Healthcare Provider Details

I. General information

NPI: 1275304016
Provider Name (Legal Business Name): DELTA RECOVERY SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HAY LONG AVE
MT PLEASANT TN
38474-1430
US

IV. Provider business mailing address

205 HAY LONG AVE
MT PLEASANT TN
38474-1430
US

V. Phone/Fax

Practice location:
  • Phone: 931-548-6901
  • Fax: 931-342-5452
Mailing address:
  • Phone: 931-548-6901
  • Fax: 931-342-5452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW WHITE
Title or Position: OWNER
Credential:
Phone: 931-548-6901