South Lake Autism Center L. L. C.

NPI #1992521116 in Saint Paul, Minnesota

Provider Information

NPI Number: 1992521116
Entity Type: Organization
Organization Name: South Lake Autism Center L. L. C.
Primary Specialty: Clinic/Center
Enumeration Date: Dec 3, 2024
Last Updated: Feb 17, 2025

Practice Location

Address: 2147 UNIVERSITY AVE W STE 109
City: Saint Paul
State: Minnesota
ZIP Code: 55114-1326
Phone: (617) 992-1536

Authorized Official

Name: SHIKHDOON JAMA WARSAME
Title: OWNER
Phone: (617) 992-1536

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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