Provider Demographics
NPI:1609689488
Name:WAYNE COUNTY ASSOCIATES LLC
Entity type:Organization
Organization Name:WAYNE COUNTY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHALLU
Authorized Official - Middle Name:
Authorized Official - Last Name:BHANOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-624-3467
Mailing Address - Street 1:18900 EUREKA RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2985
Mailing Address - Country:US
Mailing Address - Phone:734-624-3467
Mailing Address - Fax:
Practice Address - Street 1:18900 EUREKA RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2985
Practice Address - Country:US
Practice Address - Phone:734-624-3467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine