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General NPI Number Information
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NPI Number | 1073407201
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Entity Type | Organization
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Legal Business Name | ROOT AND RISE ABA PLLC
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 3008 LA LATINA DR
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City | HOUSTON
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State | TX
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Zip | 77047-0062
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Country | US
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Telephone | 414-722-8995
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Fax |
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Provider Business Mailing Address
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Address Line | 3008 LA LATINA DR
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City | HOUSTON
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State | TX
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Zip | 77047-0062
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Country | US
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Telephone | 414-722-8995
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Fax |
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Authorized Official
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Title or Position | OWNER AND FOUNDER
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Name | GINAIRIS SANTIBANEZ-TANON
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Credential | BCBA, LBA
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Telephone | 414-722-8995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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