Provider Demographics
NPI:1043606064
Name:CHATHAM RECOVERY
Entity Type:Organization
Organization Name:CHATHAM RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM SPONSOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-673-9681
Mailing Address - Street 1:1758 E 11TH ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-2845
Mailing Address - Country:US
Mailing Address - Phone:919-663-3303
Mailing Address - Fax:919-663-3305
Practice Address - Street 1:1758 E 11TH ST
Practice Address - Street 2:SUITE E
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-2845
Practice Address - Country:US
Practice Address - Phone:919-663-3303
Practice Address - Fax:919-663-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-019-065261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder