| Genesis Behavioral Services, Inc | |
|
1654 Washington Ave Racine WI 53403-2047 | |
| (262) 633-5001 | |
| (262) 633-2928 |
| Full Name | Genesis Behavioral Services, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1654 Washington Ave, Racine, Wisconsin |
| Authorized Official Name and Position | Arturo Charles Leo (SUBTANCE ABUSE COUNSELOR) |
| Authorized Official Contact | 2626335001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Behavioral Services, Inc 1654 Washington Ave Racine WI 53403-2047 Ph: (262) 633-5001 | Genesis Behavioral Services, Inc 1654 Washington Ave Racine WI 53403-2047 Ph: (262) 633-5001 |
| NPI Number | 1467627992 |
|---|---|
| Provider Enumeration Date | 04/25/2008 |
| Last Update Date | 04/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467627992 | NPI | - | NPPES |
| 10570 | Other | WI | LICENSE NUMBER |
| 39389900 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10570 (Wisconsin) | Primary |
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