Safe Haven Autism Center LLLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

SAFE HAVEN AUTISM CENTER LLLC

Practice address

9000 City Place Blvd Unit 2506
Woodbury, MN 55125-5519

Phone

(651) 428-3783

NPI assigned

Apr 29, 2024

Organization subpart

No

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

Authorized official

Name

Mohamed Mohamud KhalifNPI 1336801687

Title

Co-Owner

Phone

(651) 428-3783

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohamed Khalif

  • Behavior Analyst
  • Burnsville, MN
  • NPI 1336801687
  NPD Authorized official

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1083460208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 CITY PLACE BLVD UNIT 2506",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255519",
            "telephone_number": "651-428-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 CITY PLACE BLVD UNIT 2506",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551255519",
            "telephone_number": "651-428-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE HAVEN AUTISM CENTER LLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-28",
        "status": "A",
        "authorized_official_last_name": "KHALIF",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "MOHAMUD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "651-428-3783"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Developmental Disabilities Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.