GHA AUTISM SUPPORTS NPI 1780759787

NPI Information

NPI: 1780759787
Provider Name: GHA AUTISM SUPPORTS

Doing Business As: CAROLINA FARMS GROUP HOME #3

Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
31711 HERB FARM CIRCLE
ALBEMARLE, NC
ZIP 28001
Phone: (704) 982-9600
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GHA AUTISM SUPPORTS is a residential treatment facility, intellectual and/or developmental disabilities in Albemarle, NC. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. GHA AUTISM SUPPORTS NPI is 1780759787. The provider is registered as an organization entity type.
The provider Is Doing Business As Carolina Farms Group Home #3.

The provider's business location address is:

31711 HERB FARM CIRCLE
ALBEMARLE, NC
ZIP 28001-316
Phone: (704) 982-9600
Fax: (704) 982-8155

The provider's authorized official is Dawn Harwood Allen .
The authorized official title is Ceo and has the following contact phone number (704) 982-9600.

The enumeration date for this NPI number is 11/22/2006 and was last updated on 7/18/2015.

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	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities	MHL084061	NORTH CAROLINA	No
2	323P00000X	Psychiatric Residential Treatment Facility	MHL084061	NORTH CAROLINA	No
3	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	MHL084061	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	340615A	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: 5/5/2024

NPI Synchronization or Removal

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