Organization
WHITE SPIRIT LODGE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MICHAEL MCCARTER (MANAGER)
(865) 577-0530
Entity
Organization
Contact information
Practice address
146 MARYVILLE PIKE, SUTIE 101, KNOXVILLE, TN 37920-4185
(865) 577-0530
(865) 577-0430
Mailing address
146 MARYVILLE PIKE, SUTIE 101, KNOXVILLE, TN 37920-4185
(865) 577-0530
(865) 577-0430
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
605
TN
Other
Enumeration date
07/10/2008
Last updated
07/10/2008
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