Basic Information
| Provider Information | |||||||||
| NPI: | 1750849022 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMPREHENSIVE EARLY AUTISM SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43533 FLEETWOOD CT | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481874911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7342186632 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5877 LIVERNOIS RD | ||||||||
| Address2: | |||||||||
| City: | TROY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480983100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345456335 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2019 | ||||||||
| LastUpdateDate: | 03/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | WESSELS | ||||||||
| AuthorizedOfficialFirstName: | CINDY | ||||||||
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| AuthorizedOfficialTitleorPosition: | BEMEFITS/CREDENTIALING COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 7345456335 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.