Provider Demographics
NPI:1538040316
Name:SOMALI PARENTS AUTISM NETWORK
Entity type:Organization
Organization Name:SOMALI PARENTS AUTISM NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:PEG
Authorized Official - Middle Name:
Authorized Official - Last Name:KINDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-306-8499
Mailing Address - Street 1:310 E 38TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1300
Mailing Address - Country:US
Mailing Address - Phone:763-657-0049
Mailing Address - Fax:
Practice Address - Street 1:310 E 38TH ST STE 203
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55409-1300
Practice Address - Country:US
Practice Address - Phone:763-657-0049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health