AUTISM SERVICES OF MECKLENBURG COUNTY, INC.
NPI 1043561764
Intermediate Care Facility, Intellectual Disabilities in Charlotte, NC

Q: What is Autism Services Of Mecklenburg County, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since September 20, 2012

1123 RAVENDALE DR, CHARLOTTE, NC 28216(704) 399-3538 Get Directions Write a Review

NPPES record last updated: September 20, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Autism Services Of Mecklenburg County, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AUTISM SERVICES OF MECKLENBURG COUNTY, INC. (NPI 1043561764) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Charlotte, North Carolina and active in the NPI registry since September 2012. The organization lists Jack Marcellous Phillips, Executive Director/ceo, as its authorized official.

NPPES Registry Identity

NPI1043561764

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameAUTISM SERVICES OF MECKLENBURG COUNTY, INC.

Location Address1123 RAVENDALE DRCharlotte, NC 28216-1526

Mailing Address2211 Executive St, Suite ACharlotte, NC 28208-3661 · (704) 392-9220 · Fax (704) 392-9221

Phone(704) 399-3538

Organization SubpartNo

Authorized OfficialJack Marcellous PhillipsExecutive Director/ceo · (704) 392-9220

Enumeration DateSeptember 20, 2012

✔ NPI 1043561764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

License✔ Licensed in NC · MHL-060-231

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

1123 RAVENDALE DR, Charlotte, NC 28216

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Other Identifiers 1

Medicaid340609ANC

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Autism Services Of Mecklenburg County, Inc.'s NPI number?

The NPI number for Autism Services Of Mecklenburg County, Inc. is 1043561764. It was assigned to this organization in the NPPES registry on September 20, 2012.

Where is Autism Services Of Mecklenburg County, Inc. located?

Autism Services Of Mecklenburg County, Inc. is located at 1123 Ravendale Dr, Charlotte, NC 28216. The listed phone number is (704) 399-3538.

What is Autism Services Of Mecklenburg County, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Autism Services Of Mecklenburg County, Inc. was last updated on September 20, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.