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Autumn Carroll
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Newport Beach, California
NPI 1508572504

Autumn Carroll is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Newport Beach, CA. Autumn Carroll practices in Newport Beach, CA. The NPI Number for Autumn Carroll is 1508572504 and holds a License No. (California).

The current practice location address for Autumn Carroll is 1151 Dove St, Newport Beach, CA and can be reached out via phone at 949-630-8290.

Location: 1151 Dove St, Newport Beach, CA, 92660-2840
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508572504
Provider Name
Autumn Carroll
Credential
Provider Entity Type
Individual
Gender
Female
Address
1151 Dove St, Newport Beach, CA, 92660-2840
Phone Number
949-630-8290
Fax Number
Provider Enumeration Date
01/24/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1151 Dove St
City
Newport Beach
State
California
Zip
92660-2840
Phone Number
949-630-8290
Fax Number
person
Provider Business Mailing Address Details
Address
1151 Dove St
City
Newport Beach
State
California
Zip
92660-2840
Phone Number
949-630-8290
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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