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General NPI Number Information
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NPI Number | 1407555444
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Entity Type | Organization
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Legal Business Name | ACHIEVE AUTISM CENTER CORP
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 432 GATEWAY BLVD
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City | BURNSVILLE
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State | MN
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Zip | 55337-2559
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Country | US
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Telephone | 952-994-4835
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 W 80 1/2 ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55431-7100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ABDIRIZAK MOHAMED
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Credential |
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Telephone | 952-994-4835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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