Organization
30:17 RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MCBROOM (DIRECTOR)
(731) 215-0449
Entity
Organization
Contact information
Practice address
188 CARRIAGE HOUSE DR, JACKSON, TN 38305-3969
(731) 215-0049
(800) 418-1395
Mailing address
188 CARRIAGE HOUSE DR, JACKSON, TN 38305-3969
(731) 215-0049
(800) 418-1395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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