Organization
AUTISM SUPPORT SERVICES CENTER
Active
Organization
AUTISM SUPPORT SERVICES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKEYA NICO MARTIN (EXECUTIVE DIRECTOR)
(313) 740-7060
Entity
Organization
Contact information
Practice address
16778 NORBORNE, REDFORD CHARTER TOWNSHIP, MI 48240-3830
(313) 740-7060
Mailing address
16778 NORBORNE, REDFORD, MI 48240-2443
(313) 740-7060
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172A00000X
Driver
—
—
222Q00000X
Developmental Therapist
—
—
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
08/08/2022
Last updated
07/17/2026
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