Provider Demographics
NPI:1427299510
Name:GENESIS TREATMENT SERVICES
Entity type:Organization
Organization Name:GENESIS TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
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:P.O. BOX 194
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074
Mailing Address - Country:US
Mailing Address - Phone:410-751-7771
Mailing Address - Fax:410-751-7736
Practice Address - Street 1:1106 BUSINESS PARKWAY SOUTH
Practice Address - Street 2:SUITE B
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-751-7771
Practice Address - Fax:410-751-7736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD102262261QM2800X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD414973400Medicaid