Organization
DISCOVERY PLACE AUTISM CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDIL A FARAH (CLINICAL DIRECTOR)
(612) 816-5623
Entity
Organization
Contact information
Practice address
1701 AMERICAN BLVD E STE 7, BLOOMINGTON, MN 55425-1415
(612) 816-5623
Mailing address
1701 AMERICAN BLVD E STE 7, BLOOMINGTON, MN 55425-1415
(612) 816-5623
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
04/09/2025
Last updated
10/01/2025
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