Organization
GHA AUTISM SUPPORTS
Active
Other names
Carolina Farms Potting Shed
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN HARWOOD ALLEN (CEO)
(704) 982-9600
Entity
Organization
Contact information
Practice address
31736 HERB FARM CIRCLE, ALBEMARLE, NC 28001-6316
(704) 982-9600
(704) 982-8155
Mailing address
PO BOX 2487, ALBEMARLE, NC 28002-2487
(704) 982-9600
(704) 982-8155
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
MHL084058
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408844
—
NC
Enumeration date
06/03/2013
Last updated
06/21/2013
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