Hispanic Autism Services Of Michigan | |
51111 Woodward Ave Ste 150 Pontiac MI 48342-5037 | |
(248) 977-5310 | |
(248) 920-0386 |
Full Name | Hispanic Autism Services Of Michigan |
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Speciality | Behavior Analyst |
Location | 51111 Woodward Ave Ste 150, Pontiac, Michigan |
Authorized Official Name and Position | Jocelin Maria Henriquez (CEO) |
Authorized Official Contact | 2482542616 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Hispanic Autism Services Of Michigan 27856 Lenox Ave Madison Heights MI 48071-2730 Ph: (248) 254-2616 | Hispanic Autism Services Of Michigan 51111 Woodward Ave Ste 150 Pontiac MI 48342-5037 Ph: (248) 977-5310 |
NPI Number | 1750892337 |
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Provider Enumeration Date | 10/23/2017 |
Last Update Date | 03/11/2024 |
Certification Date | 03/11/2024 |
Medicare PECOS PAC ID | 3476968397 |
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Medicare Enrollment ID | O20210226000413 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750892337 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
Provider Name | Virgil M Williams |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114165339 PECOS PAC ID: 7416937628 Enrollment ID: I20040810000093 |
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