Provider Demographics
NPI:1992553754
Name:MIDWEST AUTISM CENTER INC
Entity type:Organization
Organization Name:MIDWEST AUTISM CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:ABDIRIZAK
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-986-0519
Mailing Address - Street 1:121 WASHINGTON AVE N # 333B
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-2503
Mailing Address - Country:US
Mailing Address - Phone:612-986-0519
Mailing Address - Fax:
Practice Address - Street 1:121 WASHINGTON AVE N # 333B
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-2503
Practice Address - Country:US
Practice Address - Phone:612-986-0519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities