Provider Demographics
NPI:1770153769
Name:TULIP HILL RECOVERY OF JACKSON
Entity type:Organization
Organization Name:TULIP HILL RECOVERY OF JACKSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:615-892-0838
Mailing Address - Street 1:228 W BALTIMORE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-6136
Mailing Address - Country:US
Mailing Address - Phone:615-892-0838
Mailing Address - Fax:
Practice Address - Street 1:228 W BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-6136
Practice Address - Country:US
Practice Address - Phone:615-892-0838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder