OrganizationActive
Autumn House
NPI 1962646836 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Greensboro, NC
Provider details
- NPI number
- 1962646836
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- Alberta Professional Services, Inc.
- Authorized official
- Derek Mitchell, Operations Manager
- License
- MHL-041-874 (NC)
Practice location
3902 Derbyshire Dr
Greensboro, NC 27410-2216
Phone: (336) 288-7360
Fax: (336) 273-6522
Mailing address
1000 Revolution Mill Dr
Greensboro, NC 27405-5082
Registry dates
- Enumerated
- 2009-04-23
- Last updated
- 2009-04-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.