| Lakes Autism Center | |
|
1069 Grandview Way # 2-317 Columbia Heights MN 55421-3376 | |
| (952) 221-6892 | |
| Not Available |
| Full Name | Lakes Autism Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1069 Grandview Way # 2-317, Columbia Heights, Minnesota |
| Authorized Official Name and Position | Safia Farah Ali (GENERAL MANAGER) |
| Authorized Official Contact | 7633294697 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakes Autism Center 1069 Grandview Way # 2-317 Columbia Heights MN 55421-3376 Ph: (952) 221-6892 | Lakes Autism Center 1069 Grandview Way # 2-317 Columbia Heights MN 55421-3376 Ph: (952) 221-6892 |
| NPI Number | 1356013312 |
|---|---|
| Provider Enumeration Date | 09/29/2021 |
| Last Update Date | 10/11/2021 |
| Certification Date | 10/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356013312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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