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Organization

PERFECTLY AUTISTIC, L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAMIKA N MERIDY QIDP (OWNER)
(770) 906-1872
Entity
Organization

Contact information

Practice address
1312 UNION AVE, BENTON HARBOR, MI 49022-5830
(269) 409-1621
Mailing address
11159 RED ARROW HWY, BRIDGMAN, MI 49106-9797
(269) 409-1621

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
343900000X
Non-emergency Medical Transport (VAN)
385H00000X
Respite Care
385HR2055X
Child Mental Illness Respite Care
Primary
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
385HR2065X
Child Physical Disabilities Respite Care

Other

Enumeration date
02/10/2023
Last updated
10/17/2023
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