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

South Lake Autism Center L. L. C.

Organization Clinic/Center · NPI 1992521116

South Lake Autism Center L. L. C. is a Clinic/Center in Saint Paul, Minnesota. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

2147 University Ave W Ste 109
Saint Paul, MN 55114-1326
Phone: (617) 992-1536
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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 number1992521116
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shikhdoon Warsame — Owner · (617) 992-1536
NPI enumeratedDecember 3, 2024
Last updated in NPPESFebruary 17, 2025
Certification dateFebruary 17, 2025
Mailing address2147 University Ave W Ste 108, Saint Paul, MN 55114-1326

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