NPIMap

Organization Active NPI

Gha Autism Supports

Doing business as Carolina Farms Group Home #4

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Albemarle, NC
National Provider Identifier
1407271737
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
GHA AUTISM SUPPORTS
Doing business as
Carolina Farms Group Home #4
Practice address
21160 Biles Rd
Albemarle, NC 28001-8014
Phone
(704) 982-9600
Fax
(704) 982-8155
NPI assigned
Feb 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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

Authorized official

Name
Dawn Harwood Allen
Title
Ceo
Phone
(704) 982-9600

Specialties & licenses 1

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

Addresses

Primary practice location

21160 Biles Rd
Albemarle, NC 28001-8014

Mailing address

213 N 2ND St
Albemarle, NC 28001-3939
Phone (704) 982-9600

Other identifiers 1

IdentifierTypeStateIssuer
3408844MedicaidNC

Other names 1

  • Carolina Farms Group Home #4 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gha Autism Supports31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

Locations

213 N 2nd St
Albemarle, NC 28001

NPI Registry JSON

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1407271737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N 2ND ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280013939",
            "telephone_number": "704-982-9600",
            "fax_number": "704-982-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21160 BILES RD",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280018014",
            "telephone_number": "704-982-9600",
            "fax_number": "704-982-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHA AUTISM SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "HARWOOD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "704-982-9600"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408844",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Farms Group Home #4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.