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NPI Code Detail

MEDICARE: SUNRISE AUTISM CENTER

MEDICARE: SUNRISE AUTISM CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1252Y00000XEarly Intervention Provider Agency

General Provider Information

NPI Number : 1265141386
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNRISE AUTISM CENTER
Provider Business Mailing Address
First Line : 14041 BURNHAVEN DR STE 150
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-4442
Country : US
Telephone Number : 612-298-1267
Fax Number :
Provider Business Practice Location Address
First Line : 14041 BURNHAVEN DR STE 150
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-4442
Country : US
Telephone Number : 612-298-1267
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AMINA HUSSEIN
Credential :
Telephone Number : 612-298-1267
Provider Enumeration Date : 11/17/2022
Last Update Date : 06/23/2026

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Directions to “SUNRISE AUTISM CENTER ” Practice Location

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