Provider Demographics
NPI:1306247689
Name:GENESIS BEHAVIORAL HEALTH, INC
Entity type:Organization
Organization Name:GENESIS BEHAVIORAL HEALTH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONZON
Authorized Official - Suffix:III
Authorized Official - Credentials:MBA
Authorized Official - Phone:661-241-5509
Mailing Address - Street 1:5201 WHITE LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-6200
Mailing Address - Country:US
Mailing Address - Phone:661-398-1800
Mailing Address - Fax:661-241-6252
Practice Address - Street 1:5201 WHITE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-6200
Practice Address - Country:US
Practice Address - Phone:661-398-1800
Practice Address - Fax:661-241-6252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit