NPIMap

Organization Active NPI

Mendota Autism Center LLC

  • Early Intervention Provider Agency
  • Mendota Heights, MN
National Provider Identifier
1720671944
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
MENDOTA AUTISM CENTER LLC
Practice address
1044 Dakota Dr
Mendota Heights, MN 55120-1266
Phone
(651) 214-8982
NPI assigned
Feb 18, 2021
Last updated
Feb 18, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Authorized official

Name
Ubah BadeNPI 1578392445
Title
Owner
Phone
(651) 214-8982

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1044 Dakota Dr
Mendota Heights, MN 55120-1266

Mailing address

1044 Dakota Dr
Mendota Heights, MN 55120-1266
Phone (651) 214-8982

National Provider Directory

National Provider Directory

Locations

1044 Dakota Dr
Mendota Heights, MN 55120
Phone (651) 214-8982

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1720671944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 DAKOTA DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201266",
            "telephone_number": "651-214-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 DAKOTA DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201266",
            "telephone_number": "651-214-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDOTA AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "BADE",
        "authorized_official_first_name": "UBAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-214-8982"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.