{"npi":"1043561764","type":"NPI-2","status":"active","name":{"display":"Autism Services Of Mecklenburg County, Inc.","other":[],"organization_name":"AUTISM SERVICES OF MECKLENBURG COUNTY, INC.","authorised_official":"Jack Phillips"},"specialty":{"primary_taxonomy":"315P00000X","primary_taxonomy_description":"Intellectual Disabilities Intermediate Care Facility","slug":"intellectual-disabilities-intermediate-care-facility","schema_org_specialty":null,"all":[{"code":"315P00000X","description":"Intellectual Disabilities Intermediate Care Facility","primary":true,"state":"NC","license":"MHL-060-231"}]},"addresses":[{"purpose":"LOCATION","street_1":"1123 RAVENDALE DR","city":"CHARLOTTE","state":"NC","postal_code":"282161526","country_code":"US","phone":"7043993538"},{"purpose":"MAILING","street_1":"2211 EXECUTIVE ST","city":"CHARLOTTE","state":"NC","postal_code":"282083661","country_code":"US","street_2":"SUITE A","phone":"7043929220","fax":"7043929221"}],"license":{"state":"NC","number":"MHL-060-231"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"340609A","state":"NC","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2012-09-20","last_updated":"2012-09-20","_meta":{"source":"NPPES","snapshot_date":"2012-09-20","doc_url":"https://findmynpi.com/api"}}