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General NPI Number Information
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NPI Number | 1154701225
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Entity Type | Organization
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Legal Business Name | LECONTE RECOVERY CENTER
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 10341 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37922-3576
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Country | US
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Telephone | 865-219-1513
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Fax |
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Provider Business Mailing Address
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Address Line | 10341 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37922-3576
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Country | US
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Telephone | 865-219-1513
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. EMILY JOHNSTON
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Credential | NP
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Telephone | 423-773-9555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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