| Discovery Place Autism Center LLC | |
|
1701 American Blvd E Ste 7 Bloomington MN 55425-1415 | |
| (612) 816-5623 | |
| Not Available |
| Full Name | Discovery Place Autism Center LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 1701 American Blvd E Ste 7, Bloomington, Minnesota |
| Authorized Official Name and Position | Idil a Farah (CLINICAL DIRECTOR) |
| Authorized Official Contact | 6128165623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Discovery Place Autism Center LLC 1701 American Blvd E Ste 7 Bloomington MN 55425-1415 Ph: (612) 816-5623 | Discovery Place Autism Center LLC 1701 American Blvd E Ste 7 Bloomington MN 55425-1415 Ph: (612) 816-5623 |
| NPI Number | 1043005366 |
|---|---|
| Provider Enumeration Date | 04/09/2025 |
| Last Update Date | 10/01/2025 |
| Certification Date | 10/01/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043005366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| 251S00000X | Community/behavioral Health | (NU) | Secondary |
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