Provider Demographics
NPI:1619093101
Name:RL PROPERTIES, INC
Entity Type:Organization
Organization Name:RL PROPERTIES, INC
Other - Org Name:RECOVERY LIVING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:STUBBLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:SAC
Authorized Official - Phone:931-520-4270
Mailing Address - Street 1:PO BOX 1073
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38503-1073
Mailing Address - Country:US
Mailing Address - Phone:931-520-4270
Mailing Address - Fax:931-520-4275
Practice Address - Street 1:390 S LOWE AVE STE 11
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-4706
Practice Address - Country:US
Practice Address - Phone:931-520-4270
Practice Address - Fax:931-520-4275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN691261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5441532Medicaid