Lilac Developmental Health LLC

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Legal business name

LILAC DEVELOPMENTAL HEALTH LLC

Practice address

4036 Shadow Oak CT
Fenton, MI 48430-9122

Phone

(989) 854-4273

NPI assigned

Mar 4, 2026

Last updated

Mar 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Audrey L Koresh, MA, BCBA, LBANPI 1093242174

Title

Behavior Analyst

Phone

(989) 854-4273

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Audrey Lynn Koresh, MA, BCBA

  • Behavior Analyst
  • Burton, MI
  • NPI 1093242174
  NPD Authorized official

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1487509402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 SHADOW OAK CT",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4036 SHADOW OAK CT",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309122",
            "telephone_number": "989-854-4273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILAC DEVELOPMENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "KORESH",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BEHAVIOR ANALYST",
        "authorized_official_telephone_number": "989-854-4273",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Behavior Analyst in Fenton, MI
• Providers in Fenton, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; 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.