Provider Demographics
NPI:1609419423
Name:EDUCARE CENTER FOR AUTISM L.L.C.
Entity Type:Organization
Organization Name:EDUCARE CENTER FOR AUTISM L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARSAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-423-7566
Mailing Address - Street 1:15245 EMBRY PATH
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-8154
Mailing Address - Country:US
Mailing Address - Phone:612-423-7566
Mailing Address - Fax:
Practice Address - Street 1:2525 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-1900
Practice Address - Country:US
Practice Address - Phone:952-808-1233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty