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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