# EAST TENNESSEE RECOVERY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** New Life Medicine, New Life Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114462215
- **Authorized official:** DANIEL TACKLING (CFO)
- **Authorized official phone:** (423) 434-6677

## Contact information

- **Practice address:** 2408 SUSANNAH ST STE 1, JOHNSON CITY, TN 37601-1765
- **Practice address phone:** (423) 434-6677
- **Practice address fax:** (423) 461-0000
- **Mailing address:** 2408 SUSANNAH ST STE 1, JOHNSON CITY, TN 37601-1765
- **Mailing address phone:** (423) 434-6677
- **Mailing address fax:** (423) 461-0000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |
| 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