=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609737865
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TQ WELLNESS AND RECOVERY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/18/2025
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 436 TODD PHILLIPS TRL
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37042-7047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-203-4141
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 436 TODD PHILLIPS TRL
-----------------------------------------------------
City | CLARKSVILLE
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37042-7047
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-203-4141
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TEGAN QUIGLEY
-----------------------------------------------------
Credential | PHD, HEALTH EDUCATOR
-----------------------------------------------------
Telephone | 808-203-4141
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174H00000X
-----------------------------------------------------
Taxonomy Name | Health Educator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------