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Contact Information

30:17 RECOVERY
188 CARRIAGE HOUSE DR
JACKSON, TN38305-3969
 Phone: 731-215-0049
 Fax: 800-418-1395
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for 3017 RECOVERY · (Female)

NPI Number 1679331284
Status Active
Credentials
Entity Individual
Enumeration date 03/08/2024
Last updated 03/08/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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