Healthcare Provider Details
I. General information
NPI: 1801618335
Provider Name (Legal Business Name): COMMITTED TO RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2024
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2039 FLETCHER CREEK DR
MEMPHIS TN
38133-7059
US
IV. Provider business mailing address
2039 FLETCHER CREEK DR
MEMPHIS TN
38133-7059
US
V. Phone/Fax
- Phone: 901-410-9062
- Fax:
- Phone: 901-410-9062
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTOPHER
GLENN
STEPHENSON
Title or Position: CIO
Credential:
Phone: 901-825-8972