Provider Demographics
NPI:1851892079
Name:WE CARE AUTISM CENTER INC.
Entity Type:Organization
Organization Name:WE CARE AUTISM CENTER INC.
Other - Org Name:WE CARE AUTISM CENTER INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARDOWSA
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MHP
Authorized Official - Phone:952-454-0421
Mailing Address - Street 1:8200 HUMBOLDT AVE S STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1433
Mailing Address - Country:US
Mailing Address - Phone:952-454-0421
Mailing Address - Fax:
Practice Address - Street 1:8200 HUMBOLDT AVE S STE 100
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1433
Practice Address - Country:US
Practice Address - Phone:952-454-0421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2187101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN=========Medicaid