Provider Demographics
NPI:1801388749
Name:NURTURING AUTISM CENTER
Entity Type:Organization
Organization Name:NURTURING AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDI
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUSSEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:612-384-6156
Mailing Address - Street 1:1712 129TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-6264
Mailing Address - Country:US
Mailing Address - Phone:612-384-6156
Mailing Address - Fax:
Practice Address - Street 1:1712 129TH AVE NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-6264
Practice Address - Country:US
Practice Address - Phone:612-384-6156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health