Organization Active NPI

Helena Autism Therapy Center

  • Early Intervention Provider Agency
  • Fridley, MN
National Provider Identifier
1295116408
Registry record updated Nov 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
CC00985 Issued in MN
Legal business name
HELENA AUTISM THERAPY CENTER
Practice address
5301 E River Rd
Suite 110
Fridley, MN 55421-1024
Phone
(763) 432-3926
NPI assigned
Jun 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2017

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

Authorized official

Name
Rachael M Tarras
Title
Director of Operations
Phone
(952) 994-3367

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X CC00985 MN Primary

Addresses

Primary practice location

5301 E River Rd
Suite 110
Fridley, MN 55421-1024

Mailing address

5301 E River Rd
Suite 110
Fridley, MN 55421-1024
Phone (763) 432-3926

Other identifiers 1

IdentifierTypeStateIssuer
1285017426MedicaidMN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1434067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512000000000",
    "number": "1295116408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 E RIVER RD",
            "address_2": "SUITE 110",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554211024",
            "telephone_number": "763-432-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 E RIVER RD",
            "address_2": "SUITE 110",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554211024",
            "telephone_number": "763-432-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HELENA AUTISM THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-12",
        "last_updated": "2017-11-30",
        "status": "A",
        "authorized_official_last_name": "TARRAS",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "952-994-3367"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MN",
            "license": "CC00985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285017426",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2017; 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.