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Organization

GENESIS BEHAVIORAL SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ARTURO CHARLES LEO BSW, CSAC (SUBTANCE ABUSE COUNSELOR)
(262) 633-5001
Entity
Organization

Contact information

Practice address
1654 WASHINGTON AVE, RACINE, WI 53403-2047
(262) 633-5001
(262) 633-2928
Mailing address
1654 WASHINGTON AVE, RACINE, WI 53403-2047
(262) 633-5001
(262) 633-2928

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10570
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10570
LICENSE NUMBER
WI
05
39389900
WI
Enumeration date
04/25/2008
Last updated
04/25/2008
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