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NPI Code Detail

MEDICARE: AUTISM SOCIETY OF NORTH CAROLINA, INC.

MEDICARE: AUTISM SOCIETY OF NORTH CAROLINA, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881751865
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTISM SOCIETY OF NORTH CAROLINA, INC.
Provider Business Mailing Address
First Line : 5121 KINGDOM WAY STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6063
Country : US
Telephone Number : 919-743-0204
Fax Number : 919-743-0208
Provider Business Practice Location Address
First Line : 5121 KINGDOM WAY STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6063
Country : US
Telephone Number : 919-743-0204
Fax Number : 919-743-0208
Authorized Official
Title or Position : CFO
Name : PAUL WENDLER
Credential :
Telephone Number : 919-865-5078
Provider Enumeration Date : 01/02/2007
Last Update Date : 05/20/2022

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