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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BH001380	OTHER	MD	BHA

General Provider Information

NPI Number	:	1871063685
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	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 W PATRICK ST
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21703-3962
Country	:	US
Telephone Number	:	240-831-4237
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOEL PRELL
Credential	:
Telephone Number	:	410-751-7771

Provider Enumeration Date	:	12/05/2018
Last Update Date	:	02/02/2026

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Directions to “GENESIS TREATMENT SERVICES, LLC ” Practice Location

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