Provider Demographics
NPI:1225517394
Name:PLAY-PLACE AUTISM & SPECIAL NEEDS CENTER
Entity Type:Organization
Organization Name:PLAY-PLACE AUTISM & SPECIAL NEEDS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:WALEASE
Authorized Official - Middle Name:LESHELL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-254-6533
Mailing Address - Street 1:39337 MOUND RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-2740
Mailing Address - Country:US
Mailing Address - Phone:586-254-6533
Mailing Address - Fax:586-991-7473
Practice Address - Street 1:39337 MOUND RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-2740
Practice Address - Country:US
Practice Address - Phone:586-254-6533
Practice Address - Fax:586-991-7473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, ChildGroup - Multi-Specialty