Provider Demographics
NPI:1982042933
Name:GHA AUTISM SUPPORTS
Entity Type:Organization
Organization Name:GHA AUTISM SUPPORTS
Other - Org Name:GHA, INC.
Other - Org Type:Former Legal Business Name
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 1:213 N 2ND ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-3939
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:2013-06-12
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC340614XMedicaid
NC3406500Medicaid
NC340614TMedicaid
NC340615AMedicaid
NC3408844Medicaid
NC3406165Medicaid
NC3406392Medicaid