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General NPI Number Information
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NPI Number | 1467897918
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Entity Type | Organization
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Legal Business Name | RECOVERY CORP
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 17 RIDGEWAY RD
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City | NORRIS
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State | TN
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Zip | 37828-3071
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Country | US
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Telephone | 865-247-5196
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Fax | 865-247-5274
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Provider Business Mailing Address
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Address Line | 6628 CENTRAL AVENUE PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37912-1400
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Country | US
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Telephone | 865-247-5196
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CONTRACTING
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Name | KAYLA DECKERT
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Credential |
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Telephone | 615-519-4156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | I000000012764
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License Number State | TN
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