NPI 1104619121

Fundamentals Autism Center LLC

Organisation Early Intervention Provider Agency Fridley, MN

Practice location

Address: 1250 Moore Lake Dr E STE 200, Fridley, MN 55432-5136
Phone: (206) 383-0514

Authorised official

Name: Hussein Mohamed Abshir
Title: Ceo
Phone: (206) 383-0514

Registered specialties

Early Intervention Provider Agency Primary

Agencies Taxonomy 252Y00000X

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Registry record

NPI: 1104619121
Entity type: Organization
NPI issued: 22 May 2025
Record last updated: 22 May 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.