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SPIRIT LAKE RECOVERY, LLC
NPI 1114168564
Substance Abuse Rehabilitation Facility in Mc Kenzie, TN

Active since March 16, 2009
1060 OLD MCKENZIE RD, MC KENZIE, TN 38201(731) 393-0304 Get Directions Write a Review

NPPES record last updated: March 16, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Spirit Lake Recovery, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SPIRIT LAKE RECOVERY, LLC (NPI 1114168564) is a healthcare organization registered as a substance abuse rehabilitation facility in Mc Kenzie, Tennessee and active in the NPI registry since March 2009. The organization lists Dan Sumrok, Owner, as its authorized official.

NPPES Registry Identity

NPI1114168564
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSPIRIT LAKE RECOVERY, LLC
Location Address1060 OLD MCKENZIE RDMc Kenzie, TN 38201-8667
Mailing Address1060 Old Mckenzie RdMc Kenzie, TN 38201-8667 · (731) 393-0304
Phone(731) 393-0304
Organization SubpartNo
Authorized OfficialDan SumrokOwner · (731) 431-3010
Enumeration DateMarch 16, 2009
✔ NPI 1114168564 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
License✔ Licensed in TN · 4072
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
1060 OLD MCKENZIE RD, Mc Kenzie, TN 38201
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Spirit Lake Recovery, LLC's NPI number?

The NPI number for Spirit Lake Recovery, LLC is 1114168564. It was assigned to this organization in the NPPES registry on March 16, 2009.

Where is Spirit Lake Recovery, LLC located?

Spirit Lake Recovery, LLC is located at 1060 Old Mckenzie Rd, Mc Kenzie, TN 38201. The listed phone number is (731) 393-0304.

What is Spirit Lake Recovery, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

When was this NPI record last updated?

The NPPES record for Spirit Lake Recovery, LLC was last updated on March 16, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.