Healthcare Provider Details

I. General information

NPI: 1659859205
Provider Name (Legal Business Name): QUANTUM RESOURCES CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2018
Last Update Date: 08/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 BEN FRANKLIN BLVD
DURHAM NC
27704-2147
US

IV. Provider business mailing address

4411 BEN FRANKLIN BLVD
DURHAM NC
27704-2147
US

V. Phone/Fax

Practice location:
  • Phone: 919-961-8377
  • Fax: 919-471-5475
Mailing address:
  • Phone: 919-961-8377
  • Fax: 919-471-5475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BASIL HALLIDAY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 919-961-8377