Organization · NPI-2

Autism Services Of Mecklenburg County, INC.

Intermediate Care Facility, Mental Illness · Charlotte, NC

NPI number1477683308

StatusActive

Last updated in NPPESSep 13, 2018

Details

NPI: 1477683308
Entity type: Organization (NPI-2)
Legal business name: Autism Services Of Mecklenburg County, INC.
Organization subpart: No
Enumeration date: Mar 7, 2007
Last updated: Sep 13, 2018

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
310500000X	Intermediate Care Facility, Mental Illness	MHL-060-231	NC	Yes
311ZA0620X	Custodial Care Facility, Adult Care Home	MHL-060-908	NC
311ZA0620X	Custodial Care Facility, Adult Care Home	MHL-060-468	NC
311ZA0620X	Custodial Care Facility, Adult Care Home	MHL-060-166	NC
315P00000X	Intermediate Care Facility, Intellectual Disabilities	–	–
251S00000X	Community/Behavioral Health	–	NC
310500000X	Intermediate Care Facility, Mental Illness	MHL-060-167	NC
310500000X	Intermediate Care Facility, Mental Illness	MHL-060-118	NC
310500000X	Intermediate Care Facility, Mental Illness	MHL-060-514	NC
311ZA0620X	Custodial Care Facility, Adult Care Home	MHL-060-350	NC

Practice location

2211-A Executive Street
Charlotte, NC 28208-3655

Phone 704-392-9220 · Fax 704-392-9221

Mailing address

2211-A Executive Street
Charlotte, NC 28208-3655

Phone 704-392-9220 · Fax 704-392-9221

Other practice locations

5026 Lansing Dr
Charlotte, NC 28270-6076

Phone 704-365-4366

5300 Kelly St
Charlotte, NC 28205-7912

Phone 704-531-1875

5215 Pinebrook Dr
Charlotte, NC 28208-2437

Phone 704-399-8969

4016 Piney Grove Rd
Charlotte, NC 28212-9012

Phone 704-399-3538

5917 Rowan Way
Charlotte, NC 28214-2403

Phone 704-391-5559

1123 Ravendale Dr
Charlotte, NC 28216-1526

Phone 704-399-3538

4319 Mantle Ct
Charlotte, NC 28205-7243

Phone 704-567-8082

4400 Dalmoor Dr
Charlotte, NC 28212-2157

Phone 704-567-1531

Authorized official

Marcy Alford
Business Manager
7043929220

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