| Willmar Autism Services Llc | |
|
425 Benson Ave Sw Willmar MN 56201-3235 | |
| (612) 570-5018 | |
| Not Available |
| Full Name | Willmar Autism Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 425 Benson Ave Sw, Willmar, Minnesota |
| Authorized Official Name and Position | Rashad Gabose (CEO/PROGRAMM MANAGER) |
| Authorized Official Contact | 6125705018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willmar Autism Services Llc 425 Benson Ave Sw Willmar MN 56201-3235 Ph: (612) 570-5018 | Willmar Autism Services Llc 425 Benson Ave Sw Willmar MN 56201-3235 Ph: (612) 570-5018 |
| NPI Number | 1831714195 |
|---|---|
| Provider Enumeration Date | 06/12/2020 |
| Last Update Date | 06/12/2020 |
| Certification Date | 06/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831714195 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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