AUTISM SERVICES OF MECKLENBURG COUNTY INC. NPI 1063764702

NPI Information

NPI: 1063764702
Provider Name: AUTISM SERVICES OF MECKLENBURG COUNTY, INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
5917 ROWAN WAY
CHARLOTTE, NC
ZIP 28214
Phone: (704) 391-5559
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AUTISM SERVICES OF MECKLENBURG COUNTY, INC. is an intermediate care facility mentally retarded in Charlotte, NC. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. AUTISM SERVICES OF MECKLENBURG COUNTY, INC. NPI is 1063764702. The provider is registered as an organization entity type.

The provider's business location address is:

5917 ROWAN WAY
CHARLOTTE, NC
ZIP 28214
Phone: (704) 391-5559
Fax: (704) 391-5560

The provider's authorized official is Jack Marcellous Phillips .
The authorized official title is Executive Director/ceo and has the following contact phone number (704) 392-9220.

The enumeration date for this NPI number is 10/4/2012 and was last updated on 1/10/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		MHL-060-514	NORTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3406022	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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