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:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306004999 | NPPES |
| Wisconsin | MEDICAID | 42185921 | |
| Wisconsin | MEDICAID | 42185900 | |
| Wisconsin | MEDICAID | 42242221 | |
| Wisconsin | MEDICAID | 42186000 |
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