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Organization
CONCERN OF DURHAM, INC
Active
Organization
CONCERN OF DURHAM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GAIL DIANE YASHAR LCSW, MS (EXECUTIVE DIRECTOR)
(919) 489-5652
Entity
Organization
Contact information
Practice address
3001 ACADEMY RD, SUITE 230, DURHAM, NC 27707-2660
(919) 489-5652
(919) 490-6288
Mailing address
3001 ACADEMY RD, 230, DURHAM, NC 27707-2660
(919) 489-5652
(919) 490-6288
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
032-054 & 032-016
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0176M
BC/BS
NC
01
—
320942
VALUE OPTIONS PROVIDER NU
NC
05
—
6603008
—
NC
05
—
6603009
—
NC
01
—
H22001
DSS PROVIDER NUMBER
NC
01
—
H22002
DSS PROVIDER NUMBER
NC
01
—
MHL-032-016
MH PROVIDER #
NC
01
—
MHL-032-054
MENTAL HEALTH PROVIDER #
NC
Enumeration date
12/19/2006
Last updated
08/23/2007
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