Healthcare Provider Details

I. General information

NPI: 1689909582
Provider Name (Legal Business Name): GENESIS BEHAVIOR CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2009
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S CENTER ST
TURLOCK CA
95380-4507
US

IV. Provider business mailing address

135 S CENTER ST
TURLOCK CA
95380-4507
US

V. Phone/Fax

Practice location:
  • Phone: 800-510-1365
  • Fax: 877-252-3970
Mailing address:
  • Phone: 800-510-1365
  • Fax: 877-252-3970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DR. ROMENA KIRYAKOUS
Title or Position: CEO
Credential: PSYD
Phone: 800-510-1365