| NPI | 1154889459 |
|---|---|
| Former Legal Business Name | T.R.A.C. THERAPY RESEARCH AUTISM CENTER |
| Entity Type | Organization |
| Authorized Contact | LISA GILLETTE Business Manager 989-513-0782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 106H00000X Marriage & Family Therapist | |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 261Q00000X Clinic/Center | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM2500X Clinic/Center Medical Specialty | |
| 261QR1100X Clinic/Center Research | |
| 261QR1300X Clinic/Center Rural Health | |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2024-02-22 |