| Rustad Autism Therapy Llc | |
|
714 6th St Sw Rochester MN 55902-2904 | |
| (612) 708-1401 | |
| Not Available |
| Full Name | Rustad Autism Therapy Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 714 6th St Sw, Rochester, Minnesota |
| Authorized Official Name and Position | Lisa A Rustad (OWNER) |
| Authorized Official Contact | 6127081401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rustad Autism Therapy Llc 714 6th St Sw Rochester MN 55902-2904 Ph: (612) 708-1401 | Rustad Autism Therapy Llc 714 6th St Sw Rochester MN 55902-2904 Ph: (612) 708-1401 |
| NPI Number | 1396984530 |
|---|---|
| Provider Enumeration Date | 02/11/2009 |
| Last Update Date | 12/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396984530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (Minnesota) | Secondary |
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