Healthcare Provider Details

I. General information

NPI: 1780871079
Provider Name (Legal Business Name): COLLABORATING CONCEPTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 01/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 FAYETTEVILLE ST SUITE 202-203
DURHAM NC
27701-3982
US

IV. Provider business mailing address

PO BOX 169
DURHAM NC
27702-0169
US

V. Phone/Fax

Practice location:
  • Phone: 919-688-3377
  • Fax:
Mailing address:
  • Phone: 919-688-3377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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 TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BILL THOMPSON
Title or Position: DIR OF OPERATIONS
Credential:
Phone: 919-688-3377