| Starlight Autism Center Llc | |
|
1405 Lilac Dr N Ste 209 Minneapolis MN 55422-4546 | |
| (612) 450-2856 | |
| Not Available |
| Full Name | Starlight Autism Center Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1405 Lilac Dr N Ste 209, Minneapolis, Minnesota |
| Authorized Official Name and Position | Hanas Kumbi (OWNER) |
| Authorized Official Contact | 6124502856 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Starlight Autism Center Llc 1405 Lilac Dr N Ste 209 Minneapolis MN 55422-4546 Ph: (612) 450-2856 | Starlight Autism Center Llc 1405 Lilac Dr N Ste 209 Minneapolis MN 55422-4546 Ph: (612) 450-2856 |
| NPI Number | 1821804501 |
|---|---|
| Provider Enumeration Date | 12/06/2024 |
| Last Update Date | 12/06/2024 |
| Certification Date | 12/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821804501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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