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Organization
EAST TENNESSEE RECOVERY, PLLC
Active
Organization
EAST TENNESSEE RECOVERY, PLLC
Active
Other names
New Life Medicine, New Life Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL TACKLING (CFO)
(423) 434-6677
Entity
Organization
Contact information
Practice address
2408 SUSANNAH ST STE 1, JOHNSON CITY, TN 37601-1765
(423) 434-6677
(423) 461-0000
Mailing address
2408 SUSANNAH ST STE 1, JOHNSON CITY, TN 37601-1765
(423) 434-6677
(423) 461-0000
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
NULL
Other
Enumeration date
12/27/2016
Last updated
12/16/2025
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