Provider Demographics
NPI:1639934276
Name:BRIGHT BEGINNINGS AUTISM CENTER
Entity Type:Organization
Organization Name:BRIGHT BEGINNINGS AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATUMO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-814-2343
Mailing Address - Street 1:1330 LAGOON AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2885
Mailing Address - Country:US
Mailing Address - Phone:612-814-2343
Mailing Address - Fax:
Practice Address - Street 1:1330 LAGOON AVE FL 4
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2885
Practice Address - Country:US
Practice Address - Phone:612-814-2343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency