Healthcare Provider Details

I. General information

NPI: 1992009732
Provider Name (Legal Business Name): UNITED AUTISM SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6184 SWAN LAKE DR
ROMULUS MI
48174-6319
US

IV. Provider business mailing address

PO BOX 335
DEARBORN HEIGHTS MI
48127-0335
US

V. Phone/Fax

Practice location:
  • Phone: 248-761-8754
  • Fax: 734-331-6868
Mailing address:
  • Phone: 313-333-3067
  • Fax: 734-331-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MONEAK D PARKER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 313-333-3067