NPIMap

Organization Active NPI

University of North Carolina at Chapel Hill-Teacch Autism Program

Doing business as Charlotte TEACCH Autism Program

  • Developmentally Disabled Services Day Training Agency
  • Charlotte, NC
National Provider Identifier
1932549482
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
3408563 Issued in NC
Legal business name
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAM
Doing business as
Charlotte TEACCH Autism Program
Practice address
5701 Executive Center Dr
Suite 108
Charlotte, NC 28212-8862
Phone
(704) 563-4103
Fax
(704) 563-4112
NPI assigned
Jun 28, 2013
Organization subpart
Yes
Parent organization
UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Authorized official

Name
Ms. Rebecca Mabe
Title
Director of Business Operations
Phone
(919) 966-8191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 3408563 NC Primary

Addresses

Primary practice location

5701 Executive Center Dr
Suite 108
Charlotte, NC 28212-8862

Mailing address

100 Renee Lynn CT
Carrboro, NC 27510-6511
Phone (919) 966-2173

Other identifiers 1

IdentifierTypeStateIssuer
3408563MedicaidNC

Other names 1

  • Charlotte TEACCH Autism Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Unc Phys and Assocs30 organizations share this tax ID, including this one
Part of
Unc Phys and Assocs

Other organizations with this tax ID 29

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

View all 29

Locations

5701 Executive Center Dr
Ste 108
Charlotte, NC 28212
Phone (704) 563-4103

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372377600000",
    "number": "1932549482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RENEE LYNN CT",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275106511",
            "telephone_number": "919-966-2173",
            "fax_number": "919-966-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 EXECUTIVE CENTER DR",
            "address_2": "SUITE 108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128862",
            "telephone_number": "704-563-4103",
            "fax_number": "704-563-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL-TEACCH AUTISM PROGRAM",
        "enumeration_date": "2013-06-28",
        "last_updated": "2013-06-28",
        "status": "A",
        "authorized_official_last_name": "MABE",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "919-966-8191",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NC",
            "license": "3408563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3408563",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charlotte TEACCH Autism Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.