Provider Demographics
NPI:1053044545
Name:ENDURANCE QUALITY MANAGEMENT
Entity Type:Organization
Organization Name:ENDURANCE QUALITY MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TAJI
Authorized Official - Middle Name:LATIFA
Authorized Official - Last Name:MITCHINER
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS OF SCIENCE
Authorized Official - Phone:919-771-5522
Mailing Address - Street 1:600 PARK OFFICES DR STE 300
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709-1012
Mailing Address - Country:US
Mailing Address - Phone:919-771-5522
Mailing Address - Fax:
Practice Address - Street 1:600 PARK OFFICES DR STE 300
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27709-1012
Practice Address - Country:US
Practice Address - Phone:919-771-5522
Practice Address - Fax:919-617-9310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health