Provider Demographics
NPI:1932821477
Name:AUTISM INSTITUTE OF MINNESOTA LLP
Entity Type:Organization
Organization Name:AUTISM INSTITUTE OF MINNESOTA LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KHADAR
Authorized Official - Middle Name:
Authorized Official - Last Name:WARDERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-309-1918
Mailing Address - Street 1:1955 UNIVERSITY AVE W STE 204
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1955 UNIVERSITY AVE W STE 204
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3724
Practice Address - Country:US
Practice Address - Phone:612-309-1918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency