| Genesee Community Services, Llc | |
|
36100 Genesee Lake Rd Oconomowoc WI 53066-9201 | |
| (262) 569-5510 | |
| (262) 569-5513 |
| Full Name | Genesee Community Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 36100 Genesee Lake Rd, Oconomowoc, Wisconsin |
| Authorized Official Name and Position | Kelly Blaschko (DIRECTOR) |
| Authorized Official Contact | 2625695510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesee Community Services, Llc 36100 Genesee Lake Rd Oconomowoc WI 53066-9201 Ph: (262) 569-5510 | Genesee Community Services, Llc 36100 Genesee Lake Rd Oconomowoc WI 53066-9201 Ph: (262) 569-5510 |
| NPI Number | 1679930655 |
|---|---|
| Provider Enumeration Date | 01/22/2016 |
| Last Update Date | 01/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679930655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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