Provider Demographics
NPI:1689727133
Name:BURKE CENTER
Entity Type:Organization
Organization Name:BURKE CENTER
Other - Org Name:HOME COMMUNITY BASED SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:ACCOUNTING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:DORTHEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-631-6149
Mailing Address - Street 1:PO BOX 151608
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-1608
Mailing Address - Country:US
Mailing Address - Phone:936-639-5380
Mailing Address - Fax:936-639-5837
Practice Address - Street 1:2105 N JOHN REDDITT DR
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904
Practice Address - Country:US
Practice Address - Phone:936-639-5380
Practice Address - Fax:936-639-5837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities