Provider Demographics
NPI:1386089605
Name:RECOVERY PHYSICIAN GROUP OF TENNESSEE, LLC
Entity type:Organization
Organization Name:RECOVERY PHYSICIAN GROUP OF TENNESSEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-345-3217
Mailing Address - Street 1:PO BOX 2323
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-2323
Mailing Address - Country:US
Mailing Address - Phone:615-345-3217
Mailing Address - Fax:
Practice Address - Street 1:101 LEA AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-2066
Practice Address - Country:US
Practice Address - Phone:615-345-3217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-30
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty