| Genesis Behavioral Llc | |
|
5604 Harmony Ave Las Vegas NV 89107-2625 | |
| (702) 981-4012 | |
| Not Available |
| Full Name | Genesis Behavioral Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5604 Harmony Ave, Las Vegas, Nevada |
| Authorized Official Name and Position | Yusleisy Collazo (MANAGING MEMBER) |
| Authorized Official Contact | 7029814012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Behavioral Llc 5604 Harmony Ave Las Vegas NV 89107-2625 Ph: (702) 981-4012 | Genesis Behavioral Llc 5604 Harmony Ave Las Vegas NV 89107-2625 Ph: (702) 981-4012 |
| NPI Number | 1760060164 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 03/30/2021 |
| Certification Date | 03/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760060164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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