ADDICTION RECOVERY CENTER OF EAST TN (NPI# 1851902639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851902639 |
| Entity Type | Organization |
| Organization Name | ADDICTION RECOVERY CENTER OF EAST TN |
| Practice Address |
3763 Highway 11 W Blountville TN 37617-3407 |
| Practice Telephone | 4232793860 |
| Practice Fax Number | 4232793861 |
| Mailing Telephone | 4232793860 |
| Mailing Fax Number | 4232793861 |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | DR. MACK LYNN HICKS (OWNER) |
| Authorized Official Telephone | 4239143195 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083A0300X |
| Street Address |
3763 HIGHWAY 11 W |
| City | BLOUNTVILLE |
| State | TN |
| Zip Code | 37617-3407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609123231 | Mildred Elaine Denton | Social Worker | 309 South Hollow Rd, Blountville, TN 37617 | 2012-08-14 |
| 1790079010 | Samuel Riddle Jones | Obstetrics & Gynecology | 594 Bill Moody Trail, Blountville, TN 37617 | 2011-06-03 |
| 1720255631 | State of Tennessee | Public Health or Welfare | Highway 126, Blountville, TN 37617 | 2008-05-09 |
| 1194933242 | Deborah E. Vantine | Dental Hygienist | 975 Emergency Drive, Blountville, TN 37617 | 2007-05-21 |
| 1285759902 | Blountville Drug Company | Pharmacy | 3090 Hwy 126, Blountville, TN 37617 | 2007-03-20 |
| 1497890396 | Gina Carolyn Stone | Registered Nurse | 154 Blountville By-pass, Blountville, TN 37617 | 2007-02-20 |
| 1801975362 | David Shannon Fritts | Chiropractor | 1323 Hwy 394, Suite C, Blountville, TN 37617 | 2006-11-03 |
| 1154320687 | Sullivan County Ems | Ambulance | 3193 Highway 126, Blountville, TN 37617 | 2005-07-18 |
| 1861696163 | Sullivan County Regional Health Department | Case Manager/Care Coordinator | 154 Blountville Bypass, Blountville, TN 37617 | 2007-06-12 |
| 1164626412 | Sullivan Health Department | Case Manager/Care Coordinator | 154 Blountville Bypass, Blountville, TN 37617 | 2007-06-12 |
| Find all providers in zip 37617 | ||||
| City | BLOUNTVILLE |
| Zip Code | 37617 |
Please comment or provide details below to improve the information on ADDICTION RECOVERY CENTER OF EAST TN.
| 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.