Provider Demographics
NPI:1366032955
Name:NORTH DAKOTA AUTISM CENTER, INC
Entity Type:Organization
Organization Name:NORTH DAKOTA AUTISM CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-277-8844
Mailing Address - Street 1:647 13TH AVE E STE A
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-3328
Mailing Address - Country:US
Mailing Address - Phone:701-367-9855
Mailing Address - Fax:701-277-8847
Practice Address - Street 1:647 13TH AVE E STE A
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3328
Practice Address - Country:US
Practice Address - Phone:701-277-8844
Practice Address - Fax:701-277-8847
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH DAKOTA AUTISM CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health