CREEKSIDE RETREAT, INC. (NPI# 1720454614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720454614 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE RETREAT, INC. |
| Practice Address |
39 Stevens Hollow Rd Taft TN 38488-5269 |
| Practice Telephone | 9314250589 |
| Mailing Telephone | 9314250589 |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2016-02-16 |
| Authorized Official Name | MARK ALAN MARTIN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9314250589 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 16877 | TN | Residential Treatment Facilities |
| Street Address |
39 STEVENS HOLLOW RD |
| City | TAFT |
| State | TN |
| Zip Code | 38488-5269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073023198 | Christie Michelle Rice | Registered Nurse | 39 Stevens Hollow Rd, Taft, TN 38488-5269 | 2017-10-03 |
| 1902331929 | Magnolia Ranch Recovery LLC | Clinic/Center | 39 Stevens Hollow Rd, Taft, TN 38488-5269 | 2017-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871068965 | Rachel Annette Clark | Advanced Practice Midwife | 1111 Old Railroad Bed Rd # 23, Taft, TN 38488-9998 | 2018-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891329793 | Claire Arellano | Specialist/Technologist | 459 Terrace Dr, Taft, CA 93268-4505 | 2020-02-28 |
| 1720611767 | Khalil Reed | Behavioral Analyst | 432 Philippine St, Taft, CA 93268-3829 | 2020-02-18 |
| 1871068965 | Rachel Annette Clark | Advanced Practice Midwife | 1111 Old Railroad Bed Rd # 23, Taft, TN 38488-9998 | 2018-10-04 |
| 1407381981 | Yaqueline Lopez | Case Manager/Care Coordinator | 102 4th St Ste B, Taft, CA 93268-3516 | 2017-04-21 |
| 1821457680 | Express Drugs | Pharmacy | 900 Kern St Ste A, Taft, CA 93268-2766 | 2016-02-22 |
| 1912314956 | Taft Union High School | Local Education Agency (LEA) | 701 Wildcat Way, Taft, CA 93268-8013 | 2014-07-22 |
| 1073940540 | Community Action Corporation of South Texas | Clinic/Center | 201 Roots Ave, Taft, TX 78390-3059 | 2013-09-30 |
| 1295161248 | Christian Quang Nguyen | Pharmacist | 301 Gardner Field Rd, Taft, CA 93268-9726 | 2013-09-23 |
| 1669718193 | Susan Marie Harrison | Counselor | 1021 4th St # B, Taft, CA 93268-2433 | 2013-01-03 |
| 1396004669 | Chad Thomas Acker | Counselor | 1021 4th Street Ste B, Taft, CA 93268 | 2012-05-08 |
| Find all providers in TAFT | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720694193 | Detox West Tennessee LLC | Substance Abuse Rehabilitation Facility | 370 N Cumberland St, Jackson, TN 38301-5470 | 2020-09-21 |
| 1003445917 | Nashville Treatment Solutions, LLC | Substance Abuse Rehabilitation Facility | 1037 Jefferson St, Nashville, TN 37208-2554 | 2020-04-02 |
| 1306476023 | Recovery Court of Sumner County, Inc. | Substance Abuse Rehabilitation Facility | 132 S Water Ave, Gallatin, TN 37066-2903 | 2020-01-22 |
| 1548890494 | Harmony Oaks Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 7609 Shallowford Rd, Chattanooga, TN 37421-2633 | 2020-01-20 |
| 1629618483 | Tennessee Recovery Clinic LLC | Substance Abuse Rehabilitation Facility | 131 Edenwold Rd, Madison, TN 37115-2428 | 2020-01-09 |
| 1598319063 | Spring 2 Life Ministries | Substance Abuse Rehabilitation Facility | 3196 Hill Creek Rd, Woodbury, TN 37190-6803 | 2019-08-01 |
| 1356994164 | Recovery Unplugged Nashville, LLC | Substance Abuse Rehabilitation Facility | 255 Wilson Pike Cir, Brentwood, TN 37027-5207 | 2019-07-21 |
| 1922590009 | Brentwood Springs Detox | Substance Abuse Rehabilitation Facility | 5935 Edmondson Pike, Nashville, TN 37211 | 2018-06-04 |
| 1801301452 | 4m Healthsystem Inc | Substance Abuse Rehabilitation Facility | 827 Virtue Rd, Knoxville, TN 37934-5344 | 2017-12-05 |
| 1477080976 | Journeypure Murfreesboro LLC | Substance Abuse Rehabilitation Facility | 1139 Nw Broad St Ste 102, Murfreesboro, TN 37129-2390 | 2017-05-15 |
| Find all providers with the same taxonomy | ||||
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| 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.