Organization
RISE EARLY INTERVENTION SERVICES LLC
Active
Organization
RISE EARLY INTERVENTION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN MANCUSO PT DPT (CHIEF OPERATING OFFICER)
(480) 295-4958
Entity
Organization
Contact information
Practice address
4554 E INVERNESS AVE, STE C3, MESA, AZ 85206-4639
(480) 295-4925
(480) 497-4756
Mailing address
4554 E INVERNESS AVE, STE C3, MESA, AZ 85206-4639
(480) 295-4925
(480) 497-4756
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
949156
—
AZ
Enumeration date
05/13/2013
Last updated
05/05/2025
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