Provider Demographics
NPI:1790348670
Name:BURTON CENTER
Entity Type:Organization
Organization Name:BURTON CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-942-8912
Mailing Address - Street 1:2605 HIGHWAY 72 221 E
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-9732
Mailing Address - Country:US
Mailing Address - Phone:864-942-8912
Mailing Address - Fax:
Practice Address - Street 1:2605 HIGHWAY 72 221 E
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-9732
Practice Address - Country:US
Practice Address - Phone:864-942-8912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BURTON CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-17
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities