Organization
HELENA AUTISM THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHAEL M TARRAS (DIRECTOR OF OPERATIONS)
(952) 994-3367
Entity
Organization
Contact information
Practice address
5301 E RIVER RD, SUITE 110, FRIDLEY, MN 55421-1024
(763) 432-3926
Mailing address
5301 E RIVER RD, SUITE 110, FRIDLEY, MN 55421-1024
(763) 432-3926
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
CC00985
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285017426
—
MN
Enumeration date
06/12/2015
Last updated
11/30/2017
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