Provider Demographics
NPI:1457058448
Name:PERFECTLY AUTISTIC, L.L.C.
Entity Type:Organization
Organization Name:PERFECTLY AUTISTIC, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAMIKA
Authorized Official - Middle Name:N
Authorized Official - Last Name:MERIDY
Authorized Official - Suffix:
Authorized Official - Credentials:QIDP
Authorized Official - Phone:770-906-1872
Mailing Address - Street 1:11159 RED ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:BRIDGMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49106-9797
Mailing Address - Country:US
Mailing Address - Phone:269-409-1621
Mailing Address - Fax:
Practice Address - Street 1:1312 UNION AVE
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-5830
Practice Address - Country:US
Practice Address - Phone:269-409-1621
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-10
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child