Healthcare Provider Details

I. General information

NPI: 1003071226
Provider Name (Legal Business Name): GENESIS TREATMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 BUSINESS PKWY S SUITE B
WESTMINSTER MD
21157-3054
US

IV. Provider business mailing address

PO BOX 194
HAMPSTEAD MD
21074-0194
US

V. Phone/Fax

Practice location:
  • Phone: 410-751-7771
  • Fax: 410-751-7736
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License NumberMD-10118-M
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL PRELL
Title or Position: PRESIDENT
Credential:
Phone: 410-751-7771