Autumn Falls, Inc.

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

MHL096159 Issued in NC

Legal business name

AUTUMN FALLS, INC.

Practice address

1016 E Ash St
Suite 3
Goldsboro, NC 27530-3854

Phone

(919) 581-8855

Fax

(919) 581-8855

NPI assigned

Jan 18, 2007

Last updated

Jun 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Arlene Smith, B.S.

Title

Administrator

Phone

(919) 581-8855

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1992857890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 E ASH ST",
            "address_2": "SUITE 3",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303854",
            "telephone_number": "919-581-8855",
            "fax_number": "919-581-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 E ASH ST",
            "address_2": "SUITE 3",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275303854",
            "telephone_number": "919-581-8855",
            "fax_number": "919-581-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN FALLS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-581-8855",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL096159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.