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General NPI Number Information
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NPI Number | 1790403236
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Entity Type | Organization
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Legal Business Name | LIFE RECOVERY AND SUPPORT
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 404 BNA DR
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City | NASHVILLE
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State | TN
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Zip | 37217-2517
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Country | US
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Telephone | 615-492-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 8011 BROOKS CHAPEL RD UNIT 982
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City | BRENTWOOD
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State | TN
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Zip | 37024-0077
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Country | US
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Telephone | 615-492-4111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER F DOZIER
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Credential | PHD
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Telephone | 615-492-4111
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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 |
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License Number State |
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