EAST TENNESSEE HEALTHCARE HOLDINGS INC


Address: 203 Gray Commons Cir Ste 110, Gray, TN 37615-5407
Phone: 4234672800

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).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
Overmountain Recovery Doing Business As Name - Organization

Office Location

Street Address 203 GRAY COMMONS CIR STE 110
City GRAY
State TN
Zip Code 37615-5407

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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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
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Competitor

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City GRAY
Zip Code 37615

Improve Information

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Dataset Information

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.

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