Sunridge Autism Center LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

SUNRIDGE AUTISM CENTER LLC

Practice address

7525 Mitchell Rd Ste 101
Eden Prairie, MN 55344-1900

Phone

(952) 465-5398

NPI assigned

Jun 23, 2025

Organization subpart

No

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

Authorized official

Name

Nadia IbrahimNPI 1609763630

Title

Managing Member

Phone

(952) 465-5398

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Nadia Ibrahim

  • Case Manager/Care Coordinator
  • Eden Prairie, MN
  • NPI 1609763630
  NPD Authorized official
• Fartun Farah, BSN

  • Behavior Technician
  • Eden Prairie, MN
  • NPI 1386521268
  NPD

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

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1356238372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 MITCHELL RD STE 101",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553441900",
            "telephone_number": "952-465-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 MITCHELL RD STE 101",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553441900",
            "telephone_number": "952-465-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRIDGE AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-22",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "952-465-5398"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Sullivan, D.O.
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• Marie Sund
• Brian Sundberg, HIS
• Alexander Robert Sundin, D.C.
• Superior Health LLC
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• Supervalu Inc
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• Surecare Nemt Services LLC

• Developmental Disabilities Clinic/Center in Eden Prairie, MN
• Providers in Eden Prairie, 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 Jun 23, 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.