Organization
AUTUMN HOUSE
Active
Parent organization
ALBERTA PROFESSIONAL SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALBERTA PROFESSIONAL SERVICES, INC.
Authorized official
MR. DEREK MITCHELL BS, QP (OPERATIONS MANAGER)
(336) 273-2640
Entity
Organization
Contact information
Practice address
3902 DERBYSHIRE DR, GREENSBORO, NC 27410-2216
(336) 288-7360
(336) 273-6522
Mailing address
1000 REVOLUTION MILL DR, STUDIO #2, GREENSBORO, NC 27405-5082
(336) 273-2640
(336) 273-6522
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
MHL-041-874
NC
Other
Enumeration date
04/23/2009
Last updated
04/23/2009
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