CREEKSIDE RETREAT INC. NPI 1720454614

NPI Information

NPI: 1720454614
Provider Name: CREEKSIDE RETREAT, INC.
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
39 STEVENS HOLLOW RD
TAFT, TN
ZIP 38488
Phone: (931) 425-0589
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CREEKSIDE RETREAT, INC. is a substance abuse rehabilitation facility in Taft, TN. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. CREEKSIDE RETREAT, INC. NPI is 1720454614. The provider is registered as an organization entity type.

The provider's business location address is:

39 STEVENS HOLLOW RD
TAFT, TN
ZIP 38488-269
Phone: (931) 425-0589

The provider's authorized official is Mark Alan Martin .
The authorized official title is Executive Director and has the following contact phone number (931) 425-0589.

The enumeration date for this NPI number is 8/14/2015 and was last updated on 2/16/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		16877	TENNESSEE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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