OrganizationActive
Autism Services of Mecklenburg County, Inc.
NPI 1578815940 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Charlotte, NC
Provider details
- NPI number
- 1578815940
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Jack Phillips, Executive Director/Ceo(704) 392-9220
- License
- 060-350 (NC)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 060-350 (NC)
Residential Treatment Facilities
Practice location
5300 Kelly St
Charlotte, NC 28205-7912
Phone: (704) 531-1875
Approximate (ZIP-level) locationGet directions
Mailing address
2211 Executive St
Charlotte, NC 28208-3661
Registry dates
- Enumerated
- 2012-10-10
- Last updated
- 2012-10-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.