Provider Demographics
NPI:1871953968
Name:GENESIS RECOVERY SERVICES, INC.
Entity type:Organization
Organization Name:GENESIS RECOVERY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALONEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-243-5130
Mailing Address - Street 1:2825 W 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-2830
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2825 W 42ND AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99517-2830
Practice Address - Country:US
Practice Address - Phone:907-243-5130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health