Provider Demographics
NPI:1730702937
Name:GHA AUTISM SUPPORTS
Entity type:Organization
Organization Name:GHA AUTISM SUPPORTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:HARWOOD
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-982-9600
Mailing Address - Street 1:PO BOX 2487
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28002-2487
Mailing Address - Country:US
Mailing Address - Phone:704-982-9600
Mailing Address - Fax:704-982-8155
Practice Address - Street 1:44012 MORROW MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-8616
Practice Address - Country:US
Practice Address - Phone:704-982-9600
Practice Address - Fax:704-982-8155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities