Organization
CREEKSIDE RETREAT, INC.
Active
Organization
CREEKSIDE RETREAT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALAN MARTIN (EXECUTIVE DIRECTOR)
(931) 425-0589
Entity
Organization
Contact information
Practice address
39 STEVENS HOLLOW RD, TAFT, TN 38488-5269
(931) 425-0589
Mailing address
39 STEVENS HOLLOW RD, TAFT, TN 38488-5269
(931) 425-0589
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
16877
TN
Other
Enumeration date
08/14/2015
Last updated
02/16/2016
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