Provider Demographics
NPI:1083287189
Name:TOGETHER WE RISE LLC
Entity Type:Organization
Organization Name:TOGETHER WE RISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PUEBLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:551-208-6348
Mailing Address - Street 1:1116 84TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-4247
Mailing Address - Country:US
Mailing Address - Phone:551-208-6348
Mailing Address - Fax:
Practice Address - Street 1:1116 84TH ST APT 1
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4247
Practice Address - Country:US
Practice Address - Phone:551-208-6348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health