Provider Demographics
NPI:1295524361
Name:SPOT FOR CHILDREN WITH SPECIAL NEEDS
Entity type:Organization
Organization Name:SPOT FOR CHILDREN WITH SPECIAL NEEDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHOSHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:848-299-3500
Mailing Address - Street 1:15809 FAIRFAX ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3015
Mailing Address - Country:US
Mailing Address - Phone:848-299-3500
Mailing Address - Fax:
Practice Address - Street 1:24632 HARDEN AVE
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-6916
Practice Address - Country:US
Practice Address - Phone:848-299-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services