| Adams Autism Center | |
|
11070 Fergus St Ne Unit B Blaine MN 55449-5072 | |
| (612) 401-3484 | |
| Not Available |
| Full Name | Adams Autism Center |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 11070 Fergus St Ne Unit B, Blaine, Minnesota |
| Authorized Official Name and Position | Ilyas Jama (OWNER) |
| Authorized Official Contact | 6124013484 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adams Autism Center 11070 Fergus St Ne Unit B Blaine MN 55449-5072 Ph: (612) 401-3484 | Adams Autism Center 11070 Fergus St Ne Unit B Blaine MN 55449-5072 Ph: (612) 401-3484 |
| NPI Number | 1013656982 |
|---|---|
| Provider Enumeration Date | 05/31/2022 |
| Last Update Date | 05/31/2022 |
| Certification Date | 05/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013656982 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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