New Life Medicine

LBN: New Life Medicine
New Life Medicine is an health care organization with primary practice located at 2408 Susannah St Ste 1 , Johnson City TN 37601-1765. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Agencies / Community/Behavioral Health, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty. New Life Medicine can be contacted via phone (423) 434-6677, or through Tackling, Daniel via phone (423) 434-6677.

Contact Information

Primary practice address
2408 Susannah St Ste 1 Johnson City TN 37601-1765
Phone: (423) 434-6677
Fax: (423) 461-0000
Website:
Map and Directions
Authorized official contact:
Name: Tackling, Daniel
Phone: (423) 434-6677

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X
Agencies / Community/Behavioral Health 251S00000X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X

Profile Details

NPI number 1114462215
LBN Legal business name New Life Medicine
DBA Doing business as New Life Medicine
Authorized official Tackling, Daniel
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2016
Last updated Aug 28th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114462215 NPPES
Tennessee MEDICAID Q026013
Tennessee MEDICAID 2017139831
Tennessee MEDICAID 7100519480

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