Provider Demographics
NPI:1073407201
Name:ROOT AND RISE ABA PLLC
Entity type:Organization
Organization Name:ROOT AND RISE ABA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:GINAIRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIBANEZ-TANON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:414-722-8995
Mailing Address - Street 1:3008 LA LATINA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-0062
Mailing Address - Country:US
Mailing Address - Phone:414-722-8995
Mailing Address - Fax:
Practice Address - Street 1:3008 LA LATINA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-0062
Practice Address - Country:US
Practice Address - Phone:414-722-8995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health