| Committed To Recovery Llc | |
|
2056 Fletcher Creek Dr Ste 101 Memphis TN 38133-7060 | |
| (901) 410-9062 | |
| Not Available |
| Full Name | Committed To Recovery Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2056 Fletcher Creek Dr Ste 101, Memphis, Tennessee |
| Authorized Official Name and Position | Christopher Stephenson (CIO) |
| Authorized Official Contact | 9018258972 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Committed To Recovery Llc 2057 Fletcher Creek Dr Memphis TN 38133-7059 Ph: (901) 410-9062 | Committed To Recovery Llc 2056 Fletcher Creek Dr Ste 101 Memphis TN 38133-7060 Ph: (901) 410-9062 |
| NPI Number | 1487435426 |
|---|---|
| Provider Enumeration Date | 10/06/2023 |
| Last Update Date | 10/28/2024 |
| Certification Date | 10/28/2024 |
| Medicare PECOS PAC ID | 8022544006 |
|---|---|
| Medicare Enrollment ID | O20241213002290 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487435426 | NPI | - | NPPES |
| Provider Name | John C Bomar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922029586 PECOS PAC ID: 4880651603 Enrollment ID: I20041214000305 |
| Provider Name | Susan G Bell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649304726 PECOS PAC ID: 8325079841 Enrollment ID: I20050824001059 |
| Provider Name | Joshua L. Carmack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013613942 PECOS PAC ID: 4789058272 Enrollment ID: I20230324000077 |
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