Organization
TRAC AUTISM CENTER INC.
Active
Other names
T.R.A.C. Therapy Research Autism Center
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GILLETTE (BUSINESS MANAGER)
(989) 513-0782
Entity
Organization
Contact information
Practice address
10751 S SAGINAW ST STE E, GRAND BLANC, MI 48439-8169
(586) 404-9400
Mailing address
3290 W BIG BEAVER RD STE 510, TROY, MI 48084-2917
(586) 404-9400
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106H00000X
Marriage & Family Therapist
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
261Q00000X
Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QR1100X
Research Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124405873
—
MI
Enumeration date
03/05/2019
Last updated
02/22/2024
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