Provider Demographics
NPI:1043943574
Name:R.I.S.E. CORP
Entity Type:Organization
Organization Name:R.I.S.E. CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MISEGADIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-333-9141
Mailing Address - Street 1:754 HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-3947
Mailing Address - Country:US
Mailing Address - Phone:720-333-9141
Mailing Address - Fax:
Practice Address - Street 1:754 HANOVER ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-3947
Practice Address - Country:US
Practice Address - Phone:720-333-9141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-01
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities