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General NPI Number Information
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NPI Number | 1568351971
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Entity Type | Organization
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Legal Business Name | BLUE SKY AUTISM CENTER LLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1405 LILAC DR N STE 250F
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City | MINNEAPOLIS
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State | MN
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Zip | 55422-4535
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Country | US
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Telephone | 619-639-3009
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 LILAC DR N STE 250F
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City | MINNEAPOLIS
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State | MN
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Zip | 55422-4535
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Country | US
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Telephone | 619-639-3009
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SIHAM SALIM SAID
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Credential |
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Telephone | 619-639-3009
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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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