Dickson Recovery Center, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

I 237-106-9373 Issued in TN

Legal business name

DICKSON RECOVERY CENTER, LLC

Practice address

222 Church St
Dickson, TN 37055-1304

Phone

(615) 560-2130

NPI assigned

Jan 8, 2007

Last updated

Aug 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jonathan Christopher Jackson

Title

Managing Member

Phone

(615) 560-2130

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218672000000",
    "number": "1780732545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 CHURCH ST",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370551304",
            "telephone_number": "615-560-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 CHURCH ST",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370551304",
            "telephone_number": "615-560-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DICKSON RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-08-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "615-560-2130",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "TN",
            "license": "I 237-106-9373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5441046",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dickson Optical PC
• Dickson Orthopaedic and Sports Medicine PLLC
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• Dickson Pain and Wellness PLLC
• Dickson Pediatric Dentistry PLLC
• Dickson Surgical Partners (Dickson Ambulatory Surgery Center)
• Kyle Diluzio, MD, DMD
• Juan S Dinkins, DO
• Martha Ann Disch, COTA
• Elizabeth Carol Diveley, LCSW

• Psychiatric Residential Treatment Facility in Dickson, TN
• Providers in Dickson, TN by specialty
• Psychiatric Residential Treatment Facility in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; 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.