Tennessee Recovery Clinic LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

TENNESSEE RECOVERY CLINIC LLC

Practice address

131 Edenwold Rd
Madison, TN 37115-2428

Phone

(615) 600-5964

NPI assigned

Dec 1, 2020

Organization subpart

Yes

Parent organization

TENNESSEE RECOVERY CLINIC LLCAs reported in NPPES

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

Authorized official

Name

Ms. Kimberly Paige Morrison

Title

Director of Clinical Compliance

Phone

(512) 278-4994

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Harold Connell Other name
• Tennessee Recovery Clinic LLC Other name

Electronic endpoints 1

Tax ID family

Tennessee Recovery Clinic LLC2 organizations share this tax ID, including this one

Part of

Tennessee Recovery Clinic LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Tennessee Recovery Clinic LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Nashville, TN
  • NPI 1629618483
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Tennessee Recovery Clinic LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Nashville, TN
  • NPI 1629618483
  NPPES parent name

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1316542012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 EDENWOLD RD",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152428",
            "telephone_number": "615-600-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 EDENWOLD RD",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371152428",
            "telephone_number": "615-600-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE RECOVERY CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TENNESSEE RECOVERY CLINIC LLC",
        "enumeration_date": "2020-12-01",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL COMPLIANCE",
        "authorized_official_telephone_number": "512-278-4994",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TN.",
            "identifier": "000000025689",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "url",
            "affiliation": "Y",
            "endpointDescription": "Direct",
            "affiliationName": "Tennessee Recovery Clinic LLC",
            "address_1": "131 Edenwold Rd",
            "city": "Madison",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371152428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Harold Connell",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Harold Connell",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tennessee Recovery Clinic LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Madison, TN
• Providers in Madison, TN by specialty
• Substance Abuse Rehabilitation Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.