Organization · NPI-2

Autism Services Of Mecklenburg County, INC.

Intermediate Care Facility, Intellectual Disabilities · Charlotte, NC

NPI number1972854693
StatusActive
Last updated in NPPESSep 20, 2012

Details

NPI
1972854693
Entity type
Organization (NPI-2)
Legal business name
Autism Services Of Mecklenburg County, INC.
Organization subpart
No
Enumeration date
Sep 20, 2012
Last updated
Sep 20, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
315P00000X Intermediate Care Facility, Intellectual DisabilitiesMHL-060-167NCYes

Practice location

4319 Mantle Ct
Charlotte, NC 28205-7243

Phone 704-567-8082

Mailing address

2211 Executive St
Suite A
Charlotte, NC 28208-3661

Phone 704-392-9220 · Fax 704-392-9221

Authorized official

Jack Marcellous Phillips
Executive Director/Ceo
7043929220

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Intermediate Care Facility, Intellectual Disabilities providers in Charlotte, NC