Organization Active NPI

Macomb Autism Center ,LLC

  • Behavior Analyst
  • Clinton TWP, MI
National Provider Identifier
1386369692
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
MACOMB AUTISM CENTER ,LLC
Practice address
43475 Dalcoma Dr Ste 208
Clinton TWP, MI 48038-3593
Phone
(313) 732-1234
NPI assigned
Oct 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bhavana VyasNPI 1720135536
Title
Ceo
Phone
(313) 732-1234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

43475 Dalcoma Dr Ste 208
Clinton TWP, MI 48038-3593

Mailing address

43475 Dalcoma Dr Ste 208
Clinton TWP, MI 48038-3593
Phone (313) 732-1234

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1386369692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR STE 208",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383593",
            "telephone_number": "313-732-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43475 DALCOMA DR STE 208",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480383593",
            "telephone_number": "313-732-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB AUTISM CENTER ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-09",
        "status": "A",
        "authorized_official_last_name": "VYAS",
        "authorized_official_first_name": "BHAVANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-732-1234"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.