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Organization
AUTISM SIBS UNIVERSE
Active
Organization
AUTISM SIBS UNIVERSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INDU EATI (CEO)
(612) 396-7422
Entity
Organization
Contact information
Practice address
14107 54TH AVE N, PLYMOUTH, MN 55446-1959
(612) 396-7422
Mailing address
19020 44TH AVE N, PLYMOUTH, MN 55446-2503
(612) 396-7422
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
NULL
171400000X
Health & Wellness Coach
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
221700000X
Art Therapist
—
NULL
221700000X
Art Therapist
—
—
2255A2300X
Athletic Trainer
—
NULL
2255A2300X
Athletic Trainer
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
251K00000X
Public Health or Welfare Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
251V00000X
Voluntary or Charitable Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261QA3000X
Augmentative Communication Clinic/Center
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
NULL
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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