Provider Demographics
NPI:1790870376
Name:RISE FOR SENIORS, P.A.
Entity Type:Organization
Organization Name:RISE FOR SENIORS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DREYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-762-2749
Mailing Address - Street 1:5201 PATHWAYS AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55110
Mailing Address - Country:US
Mailing Address - Phone:651-762-2749
Mailing Address - Fax:651-762-2749
Practice Address - Street 1:5201 PATHWAYS AVENUE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55110
Practice Address - Country:US
Practice Address - Phone:651-762-2749
Practice Address - Fax:651-762-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty