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NPI Code Detail

MEDICARE: CENTER FOR AUTISM AWARENESS AND SUPPORT LLC

MEDICARE: CENTER FOR AUTISM AWARENESS AND SUPPORT 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
1261QH0100XHealth Service Clinic/Center

General Provider Information

NPI Number : 1831748326
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR AUTISM AWARENESS AND SUPPORT LLC
Provider Business Mailing Address
First Line : 2907 CLEARWATER RD STE 100
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-6191
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2907 CLEARWATER RD STE 100
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-6191
Country : US
Telephone Number : 320-237-6571
Fax Number :
Authorized Official
Title or Position : OWNER
Name : AMAL ABDIHAMID HASSAN
Credential :
Telephone Number : 320-237-6571
Provider Enumeration Date : 09/06/2019
Last Update Date : 02/21/2025

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Directions to “CENTER FOR AUTISM AWARENESS AND SUPPORT LLC ” Practice Location

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