Provider Demographics
NPI:1225312762
Name:ZURKOT HUMAN SERVICES
Entity Type:Organization
Organization Name:ZURKOT HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BULLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-373-3213
Mailing Address - Street 1:PO BOX 2013
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27894-2013
Mailing Address - Country:US
Mailing Address - Phone:252-373-3213
Mailing Address - Fax:
Practice Address - Street 1:806 TARBORO ST W STE B
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4771
Practice Address - Country:US
Practice Address - Phone:252-373-3213
Practice Address - Fax:252-206-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-03
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-098-174261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder