Organization Name: | GENESIS TREATMENT SERVICES, LLC |
NPI Number: | 1003071226 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOEL PRELL (PRESIDENT) |
Mailing Address: | 1106 Business Pkwy S Suite B Westminster |
State: | MD US |
Postal Code: | 211573054 |
Phone Number: | 4107517771 |
Fax Number: | 4107517736 |
NPI Enumeration Date: | 07/28/2008 |
NPI Last Update Date: | 11/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM2800X |
License Number: | MD-10118-M |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Methadone Clinic |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |