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NPI Code Detail

MEDICARE: BETTER LIFE CARE AUTISM CENTER LLC

MEDICARE: BETTER LIFE CARE AUTISM CENTER LLC
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1528859501
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETTER LIFE CARE AUTISM CENTER LLC
Provider Business Mailing Address
First Line : 2931 E LAKE ST STE 204
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2691
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2931 E LAKE ST STE 204
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2691
Country : US
Telephone Number : 612-886-4558
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ATAKLIA W TADESE
Credential :
Telephone Number : 612-886-4558
Provider Enumeration Date : 05/16/2025
Last Update Date : 05/16/2025

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Directions to “BETTER LIFE CARE AUTISM CENTER LLC ” Practice Location

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