Fundamentals Autism Center LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

FUNDAMENTALS AUTISM CENTER LLC

Practice address

1250 Moore Lake Dr E Ste 200
Fridley, MN 55432-5136

Phone

(206) 383-0514

NPI assigned

May 22, 2025

Organization subpart

No

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

Authorized official

Name

Hussein Mohamed Abshir

Title

Ceo

Phone

(206) 383-0514

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1104619121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325136",
            "telephone_number": "206-383-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 MOORE LAKE DR E STE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325136",
            "telephone_number": "206-383-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNDAMENTALS AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "ABSHIR",
        "authorized_official_first_name": "HUSSEIN",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-383-0514"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Claire Freitag, M.D.
• Fridley Public Schools
• Fridley Target Clinic
• Matthew John Fritscher, LPCC
• Kristen Marie Fritsinger, MSW, LICSW
• Nariah Furlow
• Johnathan R Furzland, NP-C
• Maryane Adan Garane
• Richard William Ramsay Garcia, DC
• Catherine Lillian Noemi Gardos Reid, LICSW

• Early Intervention Provider Agency in Fridley, MN
• Providers in Fridley, MN by specialty
• Early Intervention Provider Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.