Healthcare Provider Details

I. General information

NPI: 1316751746
Provider Name (Legal Business Name): LITTLE RIVER AUTISM SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6260 HERMANTOWN RD
DULUTH MN
55810-9569
US

IV. Provider business mailing address

6260 HERMANTOWN RD
DULUTH MN
55810-9569
US

V. Phone/Fax

Practice location:
  • Phone: 218-481-8910
  • Fax:
Mailing address:
  • Phone: 218-481-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH WARD
Title or Position: CLINIC DIRECTOR
Credential: M.ED, BCBA, LBA
Phone: 218-481-8910