Provider Demographics
NPI:1497143960
Name:RECOVER APPALACHIA
Entity Type:Organization
Organization Name:RECOVER APPALACHIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-330-6105
Mailing Address - Street 1:518 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:TN
Mailing Address - Zip Code:37650-1655
Mailing Address - Country:US
Mailing Address - Phone:423-330-6105
Mailing Address - Fax:423-330-6305
Practice Address - Street 1:518 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:TN
Practice Address - Zip Code:37650-1655
Practice Address - Country:US
Practice Address - Phone:423-330-6105
Practice Address - Fax:423-330-6305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000015425261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)