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General NPI Number Information
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NPI Number | 1386133551
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Entity Type | Organization
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Legal Business Name | ENCORE HEALTH AND WELLNESS PLLC
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Dates
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Enumeration Date | 05/03/2018
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 213 LAKEVIEW RD
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City | SOMERVILLE
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State | TN
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Zip | 38068
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Country | US
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Telephone | 901-465-5466
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Fax | 901-465-9046
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Provider Business Mailing Address
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Address Line | 1550 W MCEWEN DR STE 300
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City | FRANKLIN
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State | TN
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Zip | 37067-1770
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Country | US
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Telephone | 901-465-5466
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Fax | 901-465-9048
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT BALOGH
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Credential | MD
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Telephone | 901-465-5466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MD48264
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | MD48264
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License Number State | TN
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