| Genesis Behavioral Services, Inc. | |
|
1626 Clarence Court West Bend WI 53095 | |
| (262) 338-8611 | |
| (262) 338-3367 |
| Full Name | Genesis Behavioral Services, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1626 Clarence Court, West Bend, Wisconsin |
| Authorized Official Name and Position | Pauline Ortloff (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4147771570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Behavioral Services, Inc. 12647 Olive Blvd Attn: Accts. Receiveable Saint Louis MO 63141-6393 Ph: (414) 777-1570 | Genesis Behavioral Services, Inc. 1626 Clarence Court West Bend WI 53095 Ph: (262) 338-8611 |
| NPI Number | 1306004999 |
|---|---|
| Provider Enumeration Date | 05/30/2008 |
| Last Update Date | 02/04/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306004999 | NPI | - | NPPES |
| 42185921 | Medicaid | WI | |
| 42185900 | Medicaid | WI | |
| 42242221 | Medicaid | WI | |
| 42186000 | Medicaid | WI |
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› Verified 9 days ago
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