OrganizationActive
Lifechangers Outreach
NPI 1790291334 · Substance Use Disorder Rehabilitation Clinic/Center · Kodak, TN
Provider details
- NPI number
- 1790291334
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Matthew Johnson, Executive Director(865) 805-0567
- License
- 1000000021300 (TN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2450 Winfield Dunn Pkwy
Kodak, TN 37764-2100
Phone: (865) 805-0567
Approximate (ZIP-level) locationGet directions
Mailing address
404 Holly Ct
Sevierville, TN 37862-5314
Other names (DBA / former)
- Doing business as
- Lifechangers Iop
Additional practice locations (1)
- 3677 Robert C. Byrd DriveBeckley, WV 25801Phone: (865) 805-0567
Registry dates
- Enumerated
- 2017-12-19
- Last updated
- 2018-09-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.