Provider Demographics
NPI:1730811936
Name:NU GENESIS INTEGRATIVE SOLUTIONS
Entity type:Organization
Organization Name:NU GENESIS INTEGRATIVE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-744-1137
Mailing Address - Street 1:1448 GROVE PARK DR APT 1704
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-1599
Mailing Address - Country:US
Mailing Address - Phone:133-474-4113
Mailing Address - Fax:
Practice Address - Street 1:1448 GROVE PARK DR APT 1704
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-1599
Practice Address - Country:US
Practice Address - Phone:334-744-1137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty