Healthcare Provider Details

I. General information

NPI: 1376817593
Provider Name (Legal Business Name): VERITAS COLLABORATIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 08/05/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 STIRRUP CREEK DRIVE
DURHAM NC
27703-9464
US

IV. Provider business mailing address

1295 BANDANA BLVD. SUITE 210
ST.PAUL MN
55108
US

V. Phone/Fax

Practice location:
  • Phone: 888-364-5977
  • Fax: 919-213-7003
Mailing address:
  • Phone: 888-364-5977
  • Fax: 919-213-7003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MEREDITH TRUDGEON
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 919-767-0274