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EVIDENCE BASED ADDICTION MEDICINE NPI 1093169443


NPI Information

NPI: 1093169443
Provider Name: EVIDENCE BASED ADDICTION MEDICINE

Doing Business As: HIGH POINT CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 44D2199791

Address:
205 HIGH POINT DR
JOHNSON CITY, TN
ZIP 37601
Phone: (423) 631-0731
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EVIDENCE BASED ADDICTION MEDICINE is a clinic center in Johnson City, TN. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). EVIDENCE BASED ADDICTION MEDICINE NPI is 1093169443. The provider is registered as an organization entity type.
The provider Is Doing Business As High Point Clinic.

The provider's business location address is:

205 HIGH POINT DR
JOHNSON CITY, TN
ZIP 37601-503
Phone: (423) 631-0731
Fax: (423) 631-0732

The provider's authorized official is Deanna Lynn Irick .
The authorized official title is Executive Director and has the following contact phone number (423) 631-0731.

The CLIA number assigned to this NPI record is 44D2199791 - other - med assisted treat ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/21/2016 and was last updated on 4/21/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterTENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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