Healthcare Provider Details

I. General information

NPI: 1851864755
Provider Name (Legal Business Name): HOPE AUTISM CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 04/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 PENN AVE S
BLOOMINGTON MN
55431
US

IV. Provider business mailing address

9333 PENN AVE S
BLOOMINGTON MN
55431-2320
US

V. Phone/Fax

Practice location:
  • Phone: 952-393-8233
  • Fax:
Mailing address:
  • Phone: 952-393-8233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: ELIAS N ABDI
Title or Position: MANAGER/OWNER
Credential:
Phone: 952-393-8233