# ARISE AUTISM CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487422275
- **Authorized official:** BISHARO IMAN (OWNER)
- **Authorized official phone:** (320) 260-6718

## Contact information

- **Practice address:** 3842 BEAR RIDGE AVE S, SAINT CLOUD, MN 56301-6244
- **Practice address phone:** (320) 260-6718
- **Mailing address:** 3842 BEAR RIDGE AVE S, SAINT CLOUD, MN 56301-6244
- **Mailing address phone:** (320) 260-6718

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/12/2023
- **Last updated:** 12/12/2023