Organization
RESURGENCE TENNESSEE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE LITTLETON LMFT #122999 (NATIONAL CLINICAL DIRECTOR)
(949) 244-5481
Entity
Organization
Contact information
Practice address
201 WILLIAM D JONES BLVD, FAYETTEVILLE, TN 37334-2730
(888) 700-5053
Mailing address
3151 AIRWAY AVE STE M1, COSTA MESA, CA 92626-4626
(949) 244-5481
(949) 209-5490
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124627443
FACILITY
TX
Enumeration date
11/24/2020
Last updated
04/09/2022
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