Healthcare Provider Details

I. General information

NPI: 1801126107
Provider Name (Legal Business Name): BRANCHES RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 DOW ST
MURFREESBORO TN
37130-2486
US

IV. Provider business mailing address

1102 DOW ST
MURFREESBORO TN
37130-2486
US

V. Phone/Fax

Practice location:
  • Phone: 615-904-7170
  • Fax: 866-703-0598
Mailing address:
  • Phone: 615-904-7170
  • Fax: 866-703-0598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA COURTNEY
Title or Position: DIRECTOR
Credential:
Phone: 615-904-7170