| Autism Services Of Mecklenburg County, Inc. | |
|
5026 Lansing Dr Charlotte NC 28270-6076 | |
| (704) 392-9220 | |
| (704) 392-9221 |
| Full Name | Autism Services Of Mecklenburg County, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5026 Lansing Dr, Charlotte, North Carolina |
| Authorized Official Name and Position | Jack Marcellous Phillips (EXECUTIVE DIRECTOR/CEO) |
| Authorized Official Contact | 7049217464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Services Of Mecklenburg County, Inc. 2211 Executive St Suite A Charlotte NC 28208-3661 Ph: (704) 392-9220 | Autism Services Of Mecklenburg County, Inc. 5026 Lansing Dr Charlotte NC 28270-6076 Ph: (704) 392-9220 |
| NPI Number | 1881931921 |
|---|---|
| Provider Enumeration Date | 01/09/2013 |
| Last Update Date | 01/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881931921 | NPI | - | NPPES |
| 7802270 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | MHL-060-468 (North Carolina) | Primary |
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