Grace Land Recovery LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

GRACE LAND RECOVERY LLC

Practice address

134 Timber Creek Dr
Cordova, TN 38018-4291

Phone

(901) 519-2655

Fax

(404) 698-1497

NPI assigned

Jan 27, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Brett Aric Nelson, MD

Title

Medical Director

Phone

(404) 620-9745

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1245821966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 TIMBER CREEK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184291",
            "telephone_number": "901-519-2655",
            "fax_number": "404-698-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 TIMBER CREEK DR",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184291",
            "telephone_number": "901-519-2655",
            "fax_number": "404-698-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE LAND RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "ARIC",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-620-9745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darnita Gooch, RBT
• Angel L. Gooden, LPC-MHSP, PSYD
• Clara L Goodin
• Elaina Rose Gordon, M.S
• Suzanne Walsh Gossett, MA, CCC-SLP
• Jamie Marie Grandi, LBSW, BCBA
• Dalton Ray Grant, DC
• David William Gray, PTA
• Lizzie A Gray, BFA, RBT
• Shelia A Gray

• Substance Use Disorder Rehabilitation Clinic/Center in Cordova, TN
• Providers in Cordova, TN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.