EAST TENNESSEE HEALTHCARE HOLDINGS INC (NPI# 1033624853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1033624853 |
Entity Type | Organization |
Organization Name | EAST TENNESSEE HEALTHCARE HOLDINGS INC |
Other Organization Name | OVERMOUNTAIN RECOVERY |
Practice Address |
203 Gray Commons Cir Ste 110 Gray TN 37615-5407 |
Mailing Address |
311 Princeton Rd Ste 1 Johnson City TN 37601-2026 |
Practice Telephone | 4234672800 |
Practice Fax Number | 4234679656 |
Mailing Telephone | 4234672800 |
Mailing Fax Number | 4234679656 |
Enumeration Date | 2017-12-04 |
Last Update Date | 2020-02-26 |
Authorized Official Name | MARY LYNN KRUTAK (EVP/CFO) |
Authorized Official Telephone | 4233023423 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities | ||
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Overmountain Recovery | Doing Business As Name - Organization |
Street Address |
203 GRAY COMMONS CIR STE 110 |
City | GRAY |
State | TN |
Zip Code | 37615-5407 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568962983 | Clayton Kilgore | Pharmacist | 208 Suncrest St Unit 1, Gray, TN 37615 | 2018-02-13 |
1346648268 | Jesse Mullins | Pharmacist | 121 Boone Ridge Dr, Suite 1006, Johnson City, TN 37615 | 2014-12-09 |
1750650875 | Medical Education Assistance Corporation | Pediatrics | 252 Sam Jenkins Rd, Attn: Dr. H. Patrick Stern, Gray, TN 37615 | 2011-12-19 |
1700018603 | Anna Lynne Deal | Nurse Practitioner | 119 Boone Ridge Dr., Ste. 201, Johnson City, TN 37615 | 2009-08-11 |
1285876631 | Leigh A Furman | Occupational Therapist | 253 Wiltshire Dr., Gray, TN 37615 | 2009-04-01 |
1811098908 | Fay Lynn Bembry | Nurse Practitioner | 119 Boone Ridge Drive Ste. 201, Johnson City, TN 37615 | 2006-09-25 |
1871528976 | Boones Creek Medical Pllc | Family Medicine | 2685 Boones Creek Road, Suite 104, Johnson City, TN 37615 | 2006-07-11 |
1568402048 | Joseph Vincent Pinyard Jr. | Family Medicine | 880 Boones Station Rd, Johnson City, TN 37615 | 2006-06-07 |
1548223084 | Pitchar Theerathorn | Internal Medicine | 119 Boone Ridge Drive, Suite 201, Johnson City, TN 37615 | 2006-04-07 |
1194717157 | Susan Kay Pennypacker | Nurse Practitioner | 140 Old Gray Station Rd, Suite 200, Gray, TN 37615 | 2005-08-16 |
Find all providers in zip 37615 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346850708 | Crossroads Treatment Centers of Tennessee, PC | Clinic/Center | 114 Perkins Ln, Jacksboro, TN 37757-2833 | 2020-07-31 |
1477161982 | Addiction Behavioral Care | Clinic/Center | 2617 Grandview Ave Ste 103, Nashville, TN 37211-2263 | 2020-07-21 |
1841808342 | Nashville Addiction Clinic | Clinic/Center | 5515 Edmondson Pike Ste 118, Nashville, TN 37211-5871 | 2020-07-21 |
1043828668 | Chattanooga Recovery Center LLC | Clinic/Center | 13 W Kent St Ste 201, Chattanooga, TN 37405-9913 | 2020-07-20 |
1588296131 | Integrative Health Centers LLC | Clinic/Center | 1105 16th Ave S Ste C, Nashville, TN 37212-2327 | 2020-02-11 |
1912465121 | Applegate Health Services of Tennessee, Inc | Clinic/Center | 446 Metroplex Dr Ste 200a, Nashville, TN 37211-3139 | 2019-03-06 |
1295204022 | Harpeth Recovery Clinic | Clinic/Center | 3011 Harrah Dr Ste T, Spring Hill, TN 37174-6254 | 2018-11-22 |
1861984353 | The Transition House of Tennessee, Inc. | Clinic/Center | 1024 E Mlk, Chattanooga, TN 37403-2710 | 2018-05-31 |
1265923775 | Wake Up Well Recovery LLC | Clinic/Center | 211 Donelson Pike Ste 108, Nashville, TN 37214-2929 | 2018-05-21 |
1275049215 | Holston Health Associates, Pllc | Clinic/Center | 249 E Main St Ste A, Johnson City, TN 37604-5707 | 2017-12-27 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on EAST TENNESSEE HEALTHCARE HOLDINGS INC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.