Healthcare Provider Details
I. General information
NPI: 1124912746
Provider Name (Legal Business Name): RISENOW AUTISM INNOVATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2025
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 S VALLEY RD STE 101
PAOLI PA
19301-1469
US
IV. Provider business mailing address
30 S VALLEY RD STE 101
PAOLI PA
19301-1469
US
V. Phone/Fax
- Phone: 833-940-6061
- Fax: 267-331-4002
- Phone: 833-940-6061
- Fax: 484-374-2165
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0005X |
| Taxonomy | Neurodevelopmental Disabilities Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD1600X |
| Taxonomy | Developmental Disabilities Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
D AMATO
Title or Position: MANAGING PARTNER/FOUNDER
Credential: CRNP
Phone: 484-383-0300