Provider Demographics
NPI:1134551088
Name:RECOVERY CONNECTIONS OF DURHAM INC
Entity type:Organization
Organization Name:RECOVERY CONNECTIONS OF DURHAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:BURNIS
Authorized Official - Last Name:BASS
Authorized Official - Suffix:JR
Authorized Official - Credentials:CSAC
Authorized Official - Phone:919-638-4755
Mailing Address - Street 1:2203 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1009
Mailing Address - Country:US
Mailing Address - Phone:919-638-4755
Mailing Address - Fax:
Practice Address - Street 1:2203 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1009
Practice Address - Country:US
Practice Address - Phone:919-638-4755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-032-586261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder