Provider Demographics
NPI:1194295840
Name:GENESIS TREATMENT SERVICES, LLC
Entity type:Organization
Organization Name:GENESIS TREATMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-982-8364
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-0194
Mailing Address - Country:US
Mailing Address - Phone:410-982-8364
Mailing Address - Fax:
Practice Address - Street 1:1160 W PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-3962
Practice Address - Country:US
Practice Address - Phone:240-831-4237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GENESIS TREATMENT SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-26
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder