Healthcare Provider Details

I. General information

NPI: 1215609565
Provider Name (Legal Business Name): LANDMARK RECOVERY OF TENNESSEE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 IC KING RD
SEYMOUR TN
37865-3150
US

IV. Provider business mailing address

720 COOL SPRINGS BLVD STE 500
FRANKLIN TN
37067-7259
US

V. Phone/Fax

Practice location:
  • Phone: 865-213-1080
  • Fax: 888-587-9064
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ALICIA NEAL
Title or Position: CONTRACTING SPECIALIST
Credential:
Phone: 615-281-9050