Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Reva Health Autism Center LLC

Organization Clinic/Center · NPI 1417706243

Reva Health Autism Center LLC is a Clinic/Center in Fridley, Minnesota. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

880 Moore Lake Dr W
Fridley, MN 55432-6905
Phone: (763) 245-3686
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X

Record details

NPI number1417706243
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Andrea Sampson — Owner · (763) 245-3686
NPI enumeratedMay 14, 2024
Last updated in NPPESMay 14, 2024
Certification dateMay 14, 2024
Mailing address880 Moore Lake Dr W, Fridley, MN 55432-6905

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