OrganizationActive
Spirit Lake Recovery, LLC
NPI 1114168564 · Substance Abuse Rehabilitation Facility · Mc Kenzie, TN
Provider details
- NPI number
- 1114168564
- Entity type
- Organization
- Primary specialty
- Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Dan Sumrok, Owner(731) 431-3010
- License
- 4072 (TN)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1060 Old Mckenzie Rd
Mc Kenzie, TN 38201-8667
Phone: (731) 393-0304
Street-level locationGet directions
Mailing address
1060 Old Mckenzie Rd
Mc Kenzie, TN 38201-8667
Registry dates
- Enumerated
- 2009-03-16
- Last updated
- 2009-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.