Reva Health Autism Center LLC

NPI #1417706243 in Fridley, Minnesota

Provider Information

NPI Number: 1417706243
Entity Type: Organization
Organization Name: Reva Health Autism Center LLC
Primary Specialty: Clinic/Center
Enumeration Date: May 14, 2024
Last Updated: May 14, 2024

Practice Location

Address: 880 MOORE LAKE DR W
City: Fridley
State: Minnesota
ZIP Code: 55432-6905
Phone: (763) 245-3686

Authorized Official

Name: ANDREA SAMPSON
Title: OWNER
Phone: (763) 245-3686

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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