NPIMap

Organization Active NPI

Gha Autism Supports

Doing business as Carolina Farms Group Home #3

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Albemarle, NC
National Provider Identifier
1780759787
Registry record updated Jul 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL084061 Issued in NC
Legal business name
GHA AUTISM SUPPORTS
Doing business as
Carolina Farms Group Home #3
Practice address
31711 Herb Farm Circle
Albemarle, NC 28001-6316
Phone
(704) 982-9600
Fax
(704) 982-8155
NPI assigned
Nov 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2015

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X MHL084061 NC
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL084061 NC Primary
Psychiatric Residential Treatment Facility 323P00000X MHL084061 NC

Addresses

Primary practice location

31711 Herb Farm Circle
Albemarle, NC 28001-6316

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
340615AMedicaidNC

Other names 1

  • Carolina Farms Group Home #3 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": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1780759787",
    "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": "31711 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": "2006-11-22",
        "last_updated": "2015-07-18",
        "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": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NC",
            "license": "MHL084061",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL084061",
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "NC",
            "license": "MHL084061",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340615A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Farms Group Home #3",
            "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 Jul 18, 2015; 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.