Organization Active NPI

Autism Sibs Universe

  • Developmental Disabilities Clinic/Center
  • Plymouth, MN
National Provider Identifier
1396319554
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
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 Directory

Specialties & licenses 13

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Art TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 221700000X
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 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 Registry

Primary 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.

Verify at the official NPI Registry.