NPIMap

Organization Active NPI

Autism Services, Incorporated

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Raleigh, NC
National Provider Identifier
1063570281
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
092467 Issued in NC
Legal business name
AUTISM SERVICES, INCORPORATED
Practice address
5117 Glen Forest Dr
Raleigh, NC 27612-3133
Phone
(919) 782-3353
Fax
(919) 786-0610
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Curtis Alton Bass Jr., MS
Title
Executive Director
Phone
(919) 255-9011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 092467 NC Primary

Addresses

Primary practice location

5117 Glen Forest Dr
Raleigh, NC 27612-3133

Mailing address

1310 Corporation Pkwy
Suite H
Raleigh, NC 27610-1363
Phone (919) 255-9011

Other identifiers 1

IdentifierTypeStateIssuer
7804399MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Autism Services Incorporated8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5117 Glen Forest Dr
Raleigh, NC 27612
Phone (919) 782-3353

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063570281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 CORPORATION PKWY",
            "address_2": "SUITE H",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101363",
            "telephone_number": "919-255-9011",
            "fax_number": "919-255-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5117 GLEN FOREST DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276123133",
            "telephone_number": "919-782-3353",
            "fax_number": "919-786-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM SERVICES, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_middle_name": "ALTON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "919-255-9011",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "092467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7804399",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.