Provider Demographics
NPI:1992370886
Name:RISE UP HOME CARE
Entity Type:Organization
Organization Name:RISE UP HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LALD
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIBAARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-346-3915
Mailing Address - Street 1:15451 SCHERBER LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-2678
Mailing Address - Country:US
Mailing Address - Phone:609-346-3915
Mailing Address - Fax:
Practice Address - Street 1:6108 CANDLEWOOD DR
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55443-2020
Practice Address - Country:US
Practice Address - Phone:609-346-9315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health