Active NPI
Autism Sibs Universe
- Developmental Disabilities Clinic/Center
- Plymouth, MN
National Provider Identifier
1396319554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- Legal business name
- AUTISM SIBS UNIVERSE
- Practice address
- 14107 54TH Ave N
Plymouth, MN 55446-1959 - Phone
- (612) 396-7422
- NPI assigned
- May 13, 2021
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Indu Eati
- Title
- Ceo
- Phone
- (612) 396-7422
National Provider Directory
National Provider DirectorySpecialties & licenses 13
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | |||
| General Practice Physician | 208D00000X | |||
| Art Therapist | 221700000X | |||
| Athletic Trainer | 2255A2300X | |||
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Home Health Agency | 251E00000X | |||
| Public Health or Welfare Agency | 251K00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Voluntary or Charitable Agency | 251V00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Augmentative Communication Clinic/Center | 261QA3000X | |||
| Developmental Disabilities Clinic/Center | 261QD1600X | Primary | ||
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X |
Addresses
NPPES NPI RegistryPrimary practice location
14107 54TH Ave N
Plymouth, MN 55446-1959
Mailing address
19020 44TH Ave N
Plymouth, MN 55446-2503
Phone (612) 396-7422
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 13, 2021.
{
"created_epoch": "1620864000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1620864000000",
"number": "1396319554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19020 44TH AVE N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554462503",
"telephone_number": "612-396-7422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14107 54TH AVE N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554461959",
"telephone_number": "612-396-7422"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AUTISM SIBS UNIVERSE",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-13",
"last_updated": "2021-05-13",
"certification_date": "2021-05-12",
"status": "A",
"authorized_official_last_name": "EATI",
"authorized_official_first_name": "INDU",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "612-396-7422"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Art Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251V00000X",
"taxonomy_group": "",
"desc": "Voluntary or Charitable",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QA3000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Augmentative Communication",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": null,
"license": null,
"primary": true
},
{
"code": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.