Provider Demographics
NPI:1467948521
Name:GENISYS COMPLETE RECOVERY, LLC
Entity Type:Organization
Organization Name:GENISYS COMPLETE RECOVERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:USSERY
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS
Authorized Official - Phone:828-855-9829
Mailing Address - Street 1:10 3RD AVE NE STE 400
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-5044
Mailing Address - Country:US
Mailing Address - Phone:828-855-9832
Mailing Address - Fax:
Practice Address - Street 1:10 3RD AVE NE STE 400
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5044
Practice Address - Country:US
Practice Address - Phone:828-855-9832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-02
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC573101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty