Provider Demographics
NPI:1518688613
Name:EMPOWER AUTISM CENTER
Entity Type:Organization
Organization Name:EMPOWER AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FADUMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-545-6330
Mailing Address - Street 1:3490 LEXINGTON AVE N
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-8074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3490 LEXINGTON AVE N
Practice Address - Street 2:
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-8074
Practice Address - Country:US
Practice Address - Phone:612-545-6330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency