Healthcare Provider Details

I. General information

NPI: 1235020041
Provider Name (Legal Business Name): PEER ENGAGEMENT RECOVERY & COLLABORATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3511 SHANNON RD # 376
DURHAM NC
27707-6330
US

IV. Provider business mailing address

903 PARKRIDGE RD # B
DURHAM NC
27713-9212
US

V. Phone/Fax

Practice location:
  • Phone: 919-756-4984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: TORISEJU OGUNJIMI
Title or Position: OWNER/PEER SUPPORT SPECIALIST
Credential:
Phone: 919-756-4984