Provider Demographics
NPI:1285520973
Name:MIND RISE ABA MD LLC
Entity type:Organization
Organization Name:MIND RISE ABA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AVRAHAM
Authorized Official - Middle Name:MOSHE
Authorized Official - Last Name:MEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-677-4124
Mailing Address - Street 1:10 CHISWICK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-1260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 INDUSTRIAL PARK DR STE A
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2729
Practice Address - Country:US
Practice Address - Phone:410-905-8769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health