Organization
AUTISM ADVANTAGE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUADO A ESSE (STAFF MANAGER)
(651) 410-8833
Entity
Organization
Contact information
Practice address
1111 112TH AVE NE, BLAINE, MN 55434-0009
(651) 410-8833
Mailing address
1111 112TH AVE NE, BLAINE, MN 55434-0009
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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