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General NPI Number Information
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NPI Number | 1194682682
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Entity Type | Organization
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Legal Business Name | RISING LEGACY HOME HEALTH LLC.
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 4740 42ND AVE N STE 206
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City | ROBBINSDALE
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State | MN
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Zip | 55422-1828
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Country | US
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Telephone | 763-381-7886
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Fax |
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Provider Business Mailing Address
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Address Line | 4740 42ND AVE N STE 206
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City | ROBBINSDALE
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State | MN
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Zip | 55422-1828
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Country | US
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Telephone | 763-381-7886
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASIA NICOLE FORREST
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Credential |
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Telephone | 763-381-7886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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