Provider Demographics
NPI:1598268906
Name:RISEN CONSULTANTS LLC
Entity Type:Organization
Organization Name:RISEN CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:786-277-3168
Mailing Address - Street 1:12955 SW 132ND ST STE 205A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-6224
Mailing Address - Country:US
Mailing Address - Phone:305-220-3382
Mailing Address - Fax:305-220-3383
Practice Address - Street 1:12955 SW 132ND ST STE 205A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-6224
Practice Address - Country:US
Practice Address - Phone:305-220-3382
Practice Address - Fax:305-220-3383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-12
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022612800Medicaid