# AUTISM SIBS UNIVERSE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396319554
- **Authorized official:** INDU EATI (CEO)
- **Authorized official phone:** (612) 396-7422

## Contact information

- **Practice address:** 14107 54TH AVE N, PLYMOUTH, MN 55446-1959
- **Practice address phone:** (612) 396-7422
- **Mailing address:** 19020 44TH AVE N, PLYMOUTH, MN 55446-2503
- **Mailing address phone:** (612) 396-7422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 05/13/2021
- **Last updated:** 05/13/2021