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REVA HEALTH AUTISM CENTER LLC
NPI 1417706243
Clinic/Center in Fridley, MN

Active since May 14, 2024
880 MOORE LAKE DR W, FRIDLEY, MN 55432(763) 245-3686 Get Directions Write a Review

NPPES record last updated: May 14, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Reva Health Autism Center Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REVA HEALTH AUTISM CENTER LLC (NPI 1417706243) is a healthcare organization registered as a clinic/center in Fridley, Minnesota and active in the NPI registry since May 2024. The organization lists Andrea Sampson, Owner, as its authorized official.

NPPES Registry Identity

NPI1417706243
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameREVA HEALTH AUTISM CENTER LLC
Location Address880 MOORE LAKE DR WFridley, MN 55432-6905
Mailing Address880 Moore Lake Dr WFridley, MN 55432-6905
Phone(763) 245-3686
Organization SubpartNo
Authorized OfficialAndrea SampsonOwner · (763) 245-3686
Enumeration DateMay 14, 2024
NPPES CertifiedMay 14, 2024
✔ NPI 1417706243 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
880 MOORE LAKE DR W, Fridley, MN 55432
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CITY HOME HEALTHCARE LLC
Home Health
880 MOORE LAKE DR W
FRIDLEY, MN 55432
Anoka County (763) 245-3686

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Reva Health Autism Center LLC's NPI number?

The NPI number for Reva Health Autism Center LLC is 1417706243. It was assigned to this organization in the NPPES registry on May 14, 2024.

Where is Reva Health Autism Center LLC located?

Reva Health Autism Center LLC is located at 880 Moore Lake Dr W, Fridley, MN 55432. The listed phone number is (763) 245-3686.

What is Reva Health Autism Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Reva Health Autism Center LLC was last updated on May 14, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.