Provider Demographics
NPI:1831951136
Name:SPECIAL MINDS ASD SERVICES
Entity type:Organization
Organization Name:SPECIAL MINDS ASD SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:USMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-987-3257
Mailing Address - Street 1:3188 124TH LN NE UNIT G
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-6160
Mailing Address - Country:US
Mailing Address - Phone:612-987-3257
Mailing Address - Fax:
Practice Address - Street 1:3188 124TH LN NE UNIT G
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-6160
Practice Address - Country:US
Practice Address - Phone:612-987-3257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency