NPIMap

Organization Active NPI

Gha Autism Supports

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Albemarle, NC
National Provider Identifier
1497192280
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
MHL084058 Issued in NC
Legal business name
GHA AUTISM SUPPORTS
Doing business as
Carolina Farms Potting Shed
Practice address
31736 Herb Farm Circle
Albemarle, NC 28001-6316
Phone
(704) 982-9600
Fax
(704) 982-8155
NPI assigned
Jun 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Authorized official

Name
Mrs. 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 MHL084058 NC Primary

Addresses

Primary practice location

31736 Herb Farm Circle
Albemarle, NC 28001-6316

Mailing address

PO Box 2487
Albemarle, NC 28002-2487
Phone (704) 982-9600

Other identifiers 1

IdentifierTypeStateIssuer
3408844MedicaidNC

Other names 1

  • Carolina Farms Potting Shed 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

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371772800000",
    "number": "1497192280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2487",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280022487",
            "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": "31736 HERB FARM CIRCLE",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280016316",
            "telephone_number": "704-982-9600",
            "fax_number": "704-982-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHA AUTISM SUPPORTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-21",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL084058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408844",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Farms Potting Shed",
            "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 Jun 21, 2013; 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.