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Organization

HELENA AUTISM THERAPY CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RACHAEL TARRAS MA, LMFT (DIRECTOR OF OPERATIONS)
(763) 432-3926
Entity
Organization

Contact information

Practice address
5301 E RIVER RD, SUITE 110, FRIDLEY, MN 55421-1024
(763) 432-3926
(763) 951-2132
Mailing address
5301 E RIVER RD, SUITE 110, FRIDLEY, MN 55421-1024
(763) 432-3926
(763) 951-2132

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1111
MN
251S00000X
Community/Behavioral Health Agency
Primary
1669
MN
251S00000X
Community/Behavioral Health Agency
5007
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1184804718
MN
05
1265748024
MN
05
1295731024
MN
05
1346497468
MN
Enumeration date
07/17/2013
Last updated
04/14/2018
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