Provider Demographics
NPI:1063158293
Name:CAROLINA AUSTISM INSTITUTE
Entity type:Organization
Organization Name:CAROLINA AUSTISM INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA-ED
Authorized Official - Phone:910-389-0901
Mailing Address - Street 1:325 BANNERMANS MILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHLANDS
Mailing Address - State:NC
Mailing Address - Zip Code:28574-8105
Mailing Address - Country:US
Mailing Address - Phone:910-389-0901
Mailing Address - Fax:
Practice Address - Street 1:113 G NORTH MARINE BLVD
Practice Address - Street 2:JACKSONVILLE
Practice Address - City:NC
Practice Address - State:NC
Practice Address - Zip Code:28540-6508
Practice Address - Country:US
Practice Address - Phone:910-389-0901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health