Provider Demographics
NPI:1396179156
Name:BURKE COUNCIL ON ALCOHOLISM & CHEMICAL DEPENDENCY, INC.
Entity Type:Organization
Organization Name:BURKE COUNCIL ON ALCOHOLISM & CHEMICAL DEPENDENCY, INC.
Other - Org Name:FLYNN RECOVERY COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-433-1221
Mailing Address - Street 1:203 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3417
Mailing Address - Country:US
Mailing Address - Phone:828-437-9491
Mailing Address - Fax:828-437-2190
Practice Address - Street 1:721 W UNION ST
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4208
Practice Address - Country:US
Practice Address - Phone:828-433-1221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility