Organization
PRIME AUTISM CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDIAZIZ FARAH (CEO)
(612) 517-6259
Entity
Organization
Contact information
Practice address
1710 DOUGLAS DR N STE 226E, GOLDEN VALLEY, MN 55422-4368
(612) 517-6259
Mailing address
1710 DOUGLAS DR N STE 226E, GOLDEN VALLEY, MN 55422-4368
(612) 517-6259
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
04/08/2025
Last updated
04/08/2025
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