Pathways Autism Center LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

PATHWAYS AUTISM CENTER LLC

Doing business as

PATHWAYS AUTISM CENTER LLC

Practice address

2021 E Hennepin Ave Ste 155
Minneapolis, MN 55413-1772

Phone

(612) 481-0934

NPI assigned

Oct 31, 2019

Organization subpart

No

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

Authorized official

Name

Ibrahim Abumunye

Title

Ceo

Phone

(612) 481-0934

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PATHWAYS AUTISM CENTER LLC Doing business as

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572480000000",
    "number": "1952945180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1738 NEWBRIGHTON BLVD",
            "address_2": "SUITE 104-223",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55413",
            "telephone_number": "612-481-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E HENNEPIN AVE STE 155",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131772",
            "telephone_number": "612-481-0934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1738 NEWBRIGHTON BLVD",
            "address_2": "SUITE 104-223",
            "address_purpose": "LOCATION",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55413",
            "country_code": "US",
            "telephone_number": "612-481-0934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PATHWAYS AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-10-31",
        "status": "A",
        "authorized_official_last_name": "ABUMUNYE",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-481-0934"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATHWAYS AUTISM CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adolescent and Children Mental Health Clinic/Center in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Adolescent and Children Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; 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.