Provider Demographics
NPI:1912186123
Name:THERAPEUTIC COMMUNITY RESOURCES INC
Entity Type:Organization
Organization Name:THERAPEUTIC COMMUNITY RESOURCES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:KEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:BA
Authorized Official - Phone:336-342-4911
Mailing Address - Street 1:1309 FREEWAY DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-7172
Mailing Address - Country:US
Mailing Address - Phone:336-342-4911
Mailing Address - Fax:336-342-4911
Practice Address - Street 1:1309 FREEWAY DR
Practice Address - Street 2:SUITE 2
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-7172
Practice Address - Country:US
Practice Address - Phone:336-342-4911
Practice Address - Fax:336-342-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health