Provider Demographics
NPI:1952441883
Name:CHATEAU AURORA, INC.
Entity Type:Organization
Organization Name:CHATEAU AURORA, INC.
Other - Org Name:CHATEAU AURORA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-674-1475
Mailing Address - Street 1:PO BOX 550372
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28055-0372
Mailing Address - Country:US
Mailing Address - Phone:704-674-1475
Mailing Address - Fax:803-675-4179
Practice Address - Street 1:1564 SHARON LN
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28052-5154
Practice Address - Country:US
Practice Address - Phone:704-674-1475
Practice Address - Fax:803-675-4179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL036245320600000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Not Answered385H00000XRespite Care FacilityRespite Care