Provider Demographics
NPI:1922819747
Name:IFTIIN AUTISM CENTER LLC
Entity type:Organization
Organization Name:IFTIIN AUTISM CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARDOWSA
Authorized Official - Middle Name:YAHYE
Authorized Official - Last Name:ABDINOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-402-1120
Mailing Address - Street 1:1069 GRANDVIEW WAY NE APT 101
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3372
Mailing Address - Country:US
Mailing Address - Phone:612-402-1120
Mailing Address - Fax:
Practice Address - Street 1:1069 GRANDVIEW WAY NE APT 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-3372
Practice Address - Country:US
Practice Address - Phone:612-402-1120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center