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General NPI Number Information
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NPI Number | 1457058448
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Entity Type | Organization
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Legal Business Name | PERFECTLY AUTISTIC, L.L.C.
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Dates
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Enumeration Date | 02/10/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 1312 UNION AVE
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City | BENTON HARBOR
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State | MI
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Zip | 49022-5830
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Country | US
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Telephone | 269-409-1621
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Fax |
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Provider Business Mailing Address
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Address Line | 11159 RED ARROW HWY
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City | BRIDGMAN
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State | MI
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Zip | 49106-9797
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Country | US
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Telephone | 269-409-1621
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAMIKA N MERIDY
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Credential | QIDP
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Telephone | 770-906-1872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 385HR2055X
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Taxonomy Name | Child Mental Illness Respite Care
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License Number |
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License Number State |
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