Organization
VISTA RECOVERY SYSTEMS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEDDY LEROY MOOREHOUSE LPC (SECRATARY)
(423) 631-0432
Entity
Organization
Contact information
Practice address
3114 BROWNS MILL RD, JOHNSON CITY, TN 37604-1417
(423) 631-0432
(423) 631-0284
Mailing address
3114 BROWNS MILL RD, JOHNSON CITY, TN 37604-1417
(423) 631-0432
(423) 631-0284
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC0000002819
TN
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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