Organization
WAYNE COUNTY ASSOCIATES LLC
Active
Other names
SUCCESS ON THE SPECTRUM, SOUTHGATE
Organization subpart
No
Provider details
NPI number
Authorized official
SHALLU BHANOT (CEO)
(734) 624-3467
Entity
Organization
Contact information
Practice address
18900 EUREKA RD, SOUTHGATE, MI 48195-2985
(734) 624-3467
Mailing address
18900 EUREKA RD, SOUTHGATE, MI 48195-2985
(734) 624-3467
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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