Discovery Place Autism Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DISCOVERY PLACE AUTISM CENTER LLC

Practice address

1701 American Blvd E Ste 7
Bloomington, MN 55425-1415

Phone

(612) 816-5623

NPI assigned

Apr 9, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Idil A Farah

Title

Clinical Director

Phone

(612) 816-5623

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1043005366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 AMERICAN BLVD E STE 7",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251415",
            "telephone_number": "612-816-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 AMERICAN BLVD E STE 7",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251415",
            "telephone_number": "612-816-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISCOVERY PLACE AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "IDIL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "612-816-5623"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Julie Dinca
• Haileigh Allyssah Dipietro
• Sadiyo Abdi Dirie
• Naima Hassan Diriye
• Sophie Elizabeth Dirnberger
• Lauren Distad, OTD, OTR/L
• Lauren Elizabeth Disterhaft, OD
• Jaleel Marcus Ditele
• Diversity Health Service LLC
• Andrea Marie Dixey, PT

• Clinic/Center in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.