| Autism Collaborative Center | |
|
1055 Cornell Rd Fletcher Building, Ypsilanti MI 48197-1657 | |
| (734) 485-2890 | |
| Not Available |
| Full Name | Autism Collaborative Center |
|---|---|
| Speciality | Specialist |
| Location | 1055 Cornell Rd, Ypsilanti, Michigan |
| Authorized Official Name and Position | Kristine Lynn Kastle-ruether (MANAGING DIRECTOR) |
| Authorized Official Contact | 7344872890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Collaborative Center 1055 Cornell Rd Fletcher Building, Acc Main Office Ypsilanti MI 48197-1657 Ph: () - | Autism Collaborative Center 1055 Cornell Rd Fletcher Building, Ypsilanti MI 48197-1657 Ph: (734) 485-2890 |
| NPI Number | 1568730281 |
|---|---|
| Provider Enumeration Date | 12/08/2011 |
| Last Update Date | 01/15/2019 |
| Medicare PECOS PAC ID | 9537382700 |
|---|---|
| Medicare Enrollment ID | O20140516001143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568730281 | NPI | - | NPPES |
| Provider Name | Elise Marie Jones |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1407300965 PECOS PAC ID: 2264799295 Enrollment ID: I20171130000411 |
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