NPIMap

Organization Active NPI

Genesis Behavioral Services, Inc

  • Community/Behavioral Health Agency
  • Racine, WI
National Provider Identifier
1467627992
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
10570 Issued in WI
Legal business name
GENESIS BEHAVIORAL SERVICES, INC
Practice address
1654 Washington Ave
Racine, WI 53403-2047
Phone
(262) 633-5001
Fax
(262) 633-2928
NPI assigned
Apr 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Arturo Charles Leo, BSW, CSAC
Title
Subtance Abuse Counselor
Phone
(262) 633-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 10570 WI Primary

Addresses

Primary practice location

1654 Washington Ave
Racine, WI 53403-2047

Mailing address

1654 Washington Ave
Racine, WI 53403-2047
Phone (262) 633-5001

Other identifiers 2

IdentifierTypeStateIssuer
10570OtherWILICENSE NUMBER
39389900MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Genesis Behavioral Services Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1654 Washington Ave
Racine, WI 53403
Phone (262) 633-5001

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1467627992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1654 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032047",
            "telephone_number": "262-633-5001",
            "fax_number": "262-633-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1654 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534032047",
            "telephone_number": "262-633-5001",
            "fax_number": "262-633-2928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS BEHAVIORAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "LEO",
        "authorized_official_first_name": "ARTURO",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "SUBTANCE ABUSE COUNSELOR",
        "authorized_official_telephone_number": "262-633-5001",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSW, CSAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "10570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "10570",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39389900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.