Healthcare Provider Details

I. General information

NPI: 1770420861
Provider Name (Legal Business Name): BUILDING RECOVERY COMMUNITIES COALITION NFP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S LINCOLN ST
KARNAK IL
62956-0066
US

IV. Provider business mailing address

PO BOX 66
KARNAK IL
62956-0066
US

V. Phone/Fax

Practice location:
  • Phone: 618-602-8363
  • Fax: 618-602-8363
Mailing address:
  • Phone: 618-602-8363
  • Fax: 618-634-2819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BOBBIE THOMPSON
Title or Position: PROGRAM DIRECTOR
Credential: MBA, MHP
Phone: 618-602-8363