MEDICARE: HOPE AUTISM CENTER INC

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
1	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1902518863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE AUTISM CENTER INC

Provider Business Mailing Address
First Line	:	2900 13TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1420
Country	:	US
Telephone Number	:	612-226-5846
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 13TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1420
Country	:	US
Telephone Number	:	612-226-5846
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABDULLAHI MUSSE
Credential	:
Telephone Number	:	612-226-5846

Provider Enumeration Date	:	12/21/2022
Last Update Date	:	12/21/2022

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Directions to “HOPE AUTISM CENTER INC ” Practice Location

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