Provider Demographics
NPI:1336296573
Name:ALTERNATIVES FOR PEOPLE WITH AUTISM, INC. - SHINGLE CREEK OPTION
Entity Type:Organization
Organization Name:ALTERNATIVES FOR PEOPLE WITH AUTISM, INC. - SHINGLE CREEK OPTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-560-5330
Mailing Address - Street 1:5624 73RD AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55429-1176
Mailing Address - Country:US
Mailing Address - Phone:763-560-5330
Mailing Address - Fax:763-566-8426
Practice Address - Street 1:5624 73RD AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55429-1176
Practice Address - Country:US
Practice Address - Phone:763-560-5330
Practice Address - Fax:763-566-8426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8022302RS315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities