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General NPI Number Information
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NPI Number | 1659096931
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Entity Type | Organization
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Legal Business Name | BKE ENTERPRISES, INC.
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 375 PINEHURST AVE STE 7
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City | SOUTHERN PINES
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State | NC
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Zip | 28387-7000
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Country | US
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Telephone | 910-992-7525
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Fax |
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Provider Business Mailing Address
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Address Line | 6 WAMPANOAG LN
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City | PINEHURST
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State | NC
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Zip | 28374-8840
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Country | US
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Telephone | 910-992-7525
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEVIN J. SHORT
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Credential | CADC
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Telephone | 910-992-7525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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