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Organization

RISING IMPACT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ATIF IHSAN (PROGRAM MANAGER)
(701) 729-6691
Entity
Organization

Contact information

Practice address
1821 UNIVERSITY AVE W STE 178, SAINT PAUL, MN 55104-2803
(701) 729-6691
Mailing address
1821 UNIVERSITY AVE W STE 178, SAINT PAUL, MN 55104-2803
(701) 729-6691

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
06/01/2021
Last updated
06/01/2021
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