Provider Demographics
NPI:1225372832
Name:RISING UP, LLC
Entity Type:Organization
Organization Name:RISING UP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:AT
Authorized Official - Last Name:HAPPE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:320-267-8704
Mailing Address - Street 1:3315 ROOSEVELT RD STE 200A
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-6269
Mailing Address - Country:US
Mailing Address - Phone:320-229-4069
Mailing Address - Fax:320-229-4071
Practice Address - Street 1:3315 ROOSEVELT RD STE 200A
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-6269
Practice Address - Country:US
Practice Address - Phone:320-229-4069
Practice Address - Fax:320-229-4071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN15109251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health