Provider Demographics
NPI:1003438052
Name:INSPIRE AUTISM LLC
Entity Type:Organization
Organization Name:INSPIRE AUTISM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/CCO
Authorized Official - Prefix:
Authorized Official - First Name:PAYTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUDREAU
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:248-417-4237
Mailing Address - Street 1:39525 W 14 MILE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-1635
Mailing Address - Country:US
Mailing Address - Phone:248-417-4237
Mailing Address - Fax:
Practice Address - Street 1:39525 W 14 MILE RD STE 100
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-1635
Practice Address - Country:US
Practice Address - Phone:248-417-4237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty