MEDICARE: GENESIS TREATMENT SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	261QM2800X	Methadone Clinic	MD-10118-M	MD

General Provider Information

NPI Number	:	1003071226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENESIS TREATMENT SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 194
Second Line	:
City	:	HAMPSTEAD
State	:	MD
Zip	:	21074-0194
Country	:	US
Telephone Number	:	410-982-8364
Fax Number	:

Provider Business Practice Location Address
First Line	:	1106 BUSINESS PKWY S
Second Line	:	SUITE B
City	:	WESTMINSTER
State	:	MD
Zip	:	21157-3054
Country	:	US
Telephone Number	:	410-751-7771
Fax Number	:	410-751-7736

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOEL PRELL
Credential	:
Telephone Number	:	410-982-8364

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	01/02/2025

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