Genesis Behavioral Services, Inc.

LBN: Genesis Behavioral Services, Inc.
Genesis Behavioral Services, Inc. is an health care organization with primary practice located at 1626 Clarence Court , West Bend WI 53095. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Genesis Behavioral Services, Inc. can be contacted via phone (262) 338-8611, or through Ortloff, Pauline via phone (414) 777-1570.

Contact Information

Primary practice address
1626 Clarence Court West Bend WI 53095
Phone: (262) 338-8611
Fax: (262) 338-3367
Website:
Map and Directions
Authorized official contact:
Name: Ortloff, Pauline
Phone: (414) 777-1570

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1465 Wisconsin
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 1465 Wisconsin
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 1465 Wisconsin

Profile Details

NPI number 1306004999
LBN Legal business name Genesis Behavioral Services, Inc.
DBA Doing business as
Authorized official Ortloff, Pauline
Entity Organization
Organization subpart 1 Yes
Enumeration date May 30th, 2008
Last updated Feb 4th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306004999 NPPES
Wisconsin MEDICAID 42185921
Wisconsin MEDICAID 42185900
Wisconsin MEDICAID 42242221
Wisconsin MEDICAID 42186000

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