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General NPI Number Information
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NPI Number | 1346069093
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Entity Type | Organization
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Legal Business Name | RISE AUTISM LLC
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1913 BROADWAY ST NE STE 100
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-2627
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Country | US
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Telephone | 763-353-0763
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Fax | 763-260-9898
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Provider Business Mailing Address
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Address Line | 1913 BROADWAY ST NE STE 100
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City | MINNEAPOLIS
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State | MN
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Zip | 55413-2627
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Country | US
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Telephone | 763-353-0763
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Fax | 763-260-9898
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Authorized Official
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Title or Position | OWNER
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Name | HANI A HASSAN
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Credential |
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Telephone | 763-353-0763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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