Provider Demographics
NPI:1992009732
Name:UNITED AUTISM SERVICES LLC
Entity Type:Organization
Organization Name:UNITED AUTISM SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MONEAK
Authorized Official - Middle Name:D
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-333-3067
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-0335
Mailing Address - Country:US
Mailing Address - Phone:313-333-3067
Mailing Address - Fax:734-331-6868
Practice Address - Street 1:6184 SWAN LAKE DR
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-6319
Practice Address - Country:US
Practice Address - Phone:248-761-8754
Practice Address - Fax:734-331-6868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health