Rise Incorporated

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RISE INCORPORATED

Practice address

6499 University Ave NE Ste 200
Fridley, MN 55432-4303

Phone

(763) 786-8334

Fax

(763) 786-0008

NPI assigned

Mar 13, 2007

Last updated

Aug 8, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tom Haglund

Title

Cfo

Phone

(763) 783-2817

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723075200000",
    "number": "1841323789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6499 UNIVERSITY AVE NE STE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324303",
            "telephone_number": "763-786-8334",
            "fax_number": "763-786-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6499 UNIVERSITY AVE NE STE 200",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554324303",
            "telephone_number": "763-786-8334",
            "fax_number": "763-786-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A",
        "authorized_official_last_name": "HAGLUND",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "763-783-2817",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690950700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.