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General NPI Number Information
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NPI Number | 1487534632
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Entity Type | Organization
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Legal Business Name | ARISE SERVICE LLC
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 09/06/2025
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Provider Practice Location Address
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Address Line | 4361 BEAR PATH TRL
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City | SAINT PAUL
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State | MN
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Zip | 55122-2218
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Country | US
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Telephone | 612-234-1823
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Fax | 612-371-3843
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Provider Business Mailing Address
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Address Line | 1960 CLIFF LAKE RD STE 129-124
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City | SAINT PAUL
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State | MN
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Zip | 55122-2476
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Country | US
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Telephone | 612-234-1823
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Fax | 612-371-3843
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | KEO SENGSAVANG
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Credential | LPCC
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Telephone | 612-234-2397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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