| NPI | 1992690937 |
|---|---|
| Former Legal Business Name | GENESIS BEHAVIOR CENTER, INC. |
| Entity Type | Organization |
| Authorized Contact | ROMENA NA KIRYAKOUS Owner 209-495-7724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-10 |