Discovery Place Autism Center LLC
Clinic/Center in Bloomington, MN. Organization (NPI-2).
NPI number1043005366
StatusActive
Last updated in NPPESOct 1, 2025
Details
- NPI
- 1043005366
- Entity type
- Organization (NPI-2)
- Legal business name
- Discovery Place Autism Center LLC
- Organization subpart
- No
- Enumeration date
- Apr 9, 2025
- Certification date
- Oct 1, 2025
- Last updated
- Oct 1, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 251S00000X | Community/Behavioral Health | – | – |
Practice location
1701 American Blvd E Ste 7Bloomington, MN 55425-1415
Phone 612-816-5623
Mailing address
1701 American Blvd E Ste 7Bloomington, MN 55425-1415
Phone 612-816-5623
Authorized official
Idil A Farah
Clinical Director
6128165623
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