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General NPI Number Information
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NPI Number | 1023603875
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Entity Type | Organization
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Legal Business Name | CENTERS FOR RECOVERY, LLC
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 115 W MARKET ST
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City | SMITHVILLE
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State | TN
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Zip | 37166-1725
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Country | US
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Telephone | 901-488-7447
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Fax | 888-204-4075
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Provider Business Mailing Address
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Address Line | 115 W MARKET ST
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City | SMITHVILLE
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State | TN
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Zip | 37166-1725
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Country | US
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Telephone | 901-488-7447
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Fax | 888-204-4075
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Authorized Official
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Title or Position | CEO
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Name | JEFFERY STIRNEMANN
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Credential | MD
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Telephone | 901-488-7447
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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