# CONCORD RECOVERY CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Concord Recovery Center LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386282036
- **Authorized official:** CRISSY L SHANK (BILLING)
- **Authorized official phone:** (931) 761-5732

## Contact information

- **Practice address:** 601 S CONCORD ST STE 108, KNOXVILLE, TN 37919-3339
- **Practice address phone:** (865) 985-0371
- **Practice address fax:** (865) 985-0649
- **Mailing address:** 601 S CONCORD ST STE 108, KNOXVILLE, TN 37919-3339
- **Mailing address phone:** (865) 985-0371
- **Mailing address fax:** (865) 985-0649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/12/2019
- **Last updated:** 05/25/2021