| Foundations Autism Center, Pllc | |
|
1908 Kruchten Ct S Sartell MN 56377-4645 | |
| (320) 290-0693 | |
| Not Available |
| Full Name | Foundations Autism Center, Pllc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 1908 Kruchten Ct S, Sartell, Minnesota |
| Authorized Official Name and Position | Kristine Wainright-tadych (CEO) |
| Authorized Official Contact | 3202900693 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Foundations Autism Center, Pllc 2607 Regal Rd Saint Cloud MN 56301-9055 Ph: (320) 290-0693 | Foundations Autism Center, Pllc 1908 Kruchten Ct S Sartell MN 56377-4645 Ph: (320) 290-0693 |
| NPI Number | 1255041992 |
|---|---|
| Provider Enumeration Date | 12/05/2022 |
| Last Update Date | 12/05/2022 |
| Certification Date | 12/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255041992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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