Provider Demographics
NPI:1245979178
Name:ALL LEVEL AUTISM SUCCESS LLC
Entity type:Organization
Organization Name:ALL LEVEL AUTISM SUCCESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMEDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:952-297-7855
Mailing Address - Street 1:11178 ABLE ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55434-5505
Mailing Address - Country:US
Mailing Address - Phone:952-297-7855
Mailing Address - Fax:612-979-2109
Practice Address - Street 1:5015 GARLAND LN N APT A
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-2466
Practice Address - Country:US
Practice Address - Phone:952-297-7855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty