Organization
GHA AUTISM SUPPORTS
Active
Other names
Port City Academy
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN HARWOOD ALLEN (CEO)
(704) 982-9600
Entity
Organization
Contact information
Practice address
20 N 4TH ST, SUITE 300B, WILMINGTON, NC 28401-4553
(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
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408844
—
NC
Enumeration date
09/03/2013
Last updated
09/28/2020
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