Provider Demographics
NPI:1760104392
Name:APPALACHIAN HIGHLANDS RECOVERY LLC
Entity Type:Organization
Organization Name:APPALACHIAN HIGHLANDS RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-782-9266
Mailing Address - Street 1:7062 CARTERS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHURCH HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37642-6320
Mailing Address - Country:US
Mailing Address - Phone:423-782-9266
Mailing Address - Fax:
Practice Address - Street 1:7062 CARTERS VALLEY RD
Practice Address - Street 2:
Practice Address - City:CHURCH HILL
Practice Address - State:TN
Practice Address - Zip Code:37642-6320
Practice Address - Country:US
Practice Address - Phone:423-782-9266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Single Specialty