Provider Demographics
NPI:1467897918
Name:RECOVERY CORP
Entity Type:Organization
Organization Name:RECOVERY CORP
Other - Org Name:SERENITY CENTERS OF TENNESSEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-519-4156
Mailing Address - Street 1:6628 CENTRAL AVENUE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-1400
Mailing Address - Country:US
Mailing Address - Phone:865-247-5196
Mailing Address - Fax:
Practice Address - Street 1:17 RIDGEWAY RD
Practice Address - Street 2:
Practice Address - City:NORRIS
Practice Address - State:TN
Practice Address - Zip Code:37828-3071
Practice Address - Country:US
Practice Address - Phone:865-247-5196
Practice Address - Fax:865-247-5274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000012764324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility