Provider Demographics
NPI:1750849022
Name:COMPREHENSIVE EARLY AUTISM SERVICES
Entity Type:Organization
Organization Name:COMPREHENSIVE EARLY AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEMEFITS/CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WESSELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-545-6335
Mailing Address - Street 1:43533 FLEETWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4911
Mailing Address - Country:US
Mailing Address - Phone:734-218-6632
Mailing Address - Fax:
Practice Address - Street 1:5877 LIVERNOIS RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-3100
Practice Address - Country:US
Practice Address - Phone:734-545-6335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health