Salahudin Awil Abdikadir

Individual provider Active NPI Behavior Technician · Shoreview, MN

NPI 1710794367 · NPPES record last updated Dec 17, 2024

Key facts

NPI
1710794367
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
4186 Lexington Ave N
Shoreview, MN 55126-5512
Phone
(612) 644-8021
NPI assigned
Dec 17, 2024
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Caring Paradise L. L. C. Current
since Sep 14, 2025
Accepting new patients

Locations

4186 Lexington Ave N
Shoreview, MN 55126
Phone (612) 644-8021

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

4186 Lexington Ave N
Shoreview, MN 55126-5512

Mailing address

4186 Lexington Ave N
Shoreview, MN 55126
Phone (612) 644-8021

Other providers in Shoreview, MN

All providers in Shoreview, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.