| Genesis Behavioral Health Care Services, Inc. | |
|
34 Oak St East Ellijay GA 30540-8151 | |
| (706) 636-5679 | |
| (706) 636-5680 |
| Full Name | Genesis Behavioral Health Care Services, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 34 Oak St, East Ellijay, Georgia |
| Authorized Official Name and Position | Gary L Rogers (CHAIRMAN CEO) |
| Authorized Official Contact | 7066365679 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Behavioral Health Care Services, Inc. 34 Oak St P O Box 1659 East Ellijay GA 30540-8151 Ph: (706) 636-5679 | Genesis Behavioral Health Care Services, Inc. 34 Oak St East Ellijay GA 30540-8151 Ph: (706) 636-5679 |
| NPI Number | 1831264118 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1759378870 |
|---|---|
| Medicare Enrollment ID | O20040429000435 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831264118 | NPI | - | NPPES |
| 00626315E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1824 (Georgia) | Primary |
| Provider Name | Gary L Rogers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922172683 PECOS PAC ID: 4183722184 Enrollment ID: I20080225000005 |
Gencare Of Georgia, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 Kiker St, East Ellijay, GA 30540 Phone: 706-276-2273 Fax: 706-276-2277 |