Provider Demographics
NPI:1366115248
Name:AUTHORACARE COLLECTIVE
Entity type:Organization
Organization Name:AUTHORACARE COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DURHAM
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:336-532-0125
Mailing Address - Street 1:914 CHAPEL HILL RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-6715
Mailing Address - Country:US
Mailing Address - Phone:336-532-0125
Mailing Address - Fax:336-532-0900
Practice Address - Street 1:2500 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4522
Practice Address - Country:US
Practice Address - Phone:336-621-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUTHORACARE COLLECTIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty