Provider Demographics
NPI:1518950609
Name:MEMPHIS RECOVERY CENTERS, INC.
Entity Type:Organization
Organization Name:MEMPHIS RECOVERY CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLOUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-272-7751
Mailing Address - Street 1:219 N MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6931
Mailing Address - Country:US
Mailing Address - Phone:901-272-7751
Mailing Address - Fax:
Practice Address - Street 1:219 N MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-6931
Practice Address - Country:US
Practice Address - Phone:901-272-7751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000014324500000X
324500000X
TN00000000133245S0500X
TN00000000153245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children