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General NPI Number Information
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NPI Number | 1285520973
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Entity Type | Organization
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Legal Business Name | MIND RISE ABA MD LLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 2 INDUSTRIAL PARK DR STE A
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City | WALDORF
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State | MD
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Zip | 20602-2729
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Country | US
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Telephone | 410-905-8769
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CHISWICK DR
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City | JACKSON
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State | NJ
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Zip | 08527-1260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | AVRAHAM MOSHE MEISTER
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Credential |
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Telephone | 732-677-4124
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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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