Provider Demographics
NPI:1083351381
Name:RAISING OUR COMMUNITY LLC
Entity Type:Organization
Organization Name:RAISING OUR COMMUNITY LLC
Other - Org Name:RAISING OUR COMMUNITY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER/OWN
Authorized Official - Prefix:MR
Authorized Official - First Name:RILWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADIGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-541-6008
Mailing Address - Street 1:885 NW 81ST WAY
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1254
Mailing Address - Country:US
Mailing Address - Phone:786-541-6008
Mailing Address - Fax:754-206-3395
Practice Address - Street 1:885 NW 81ST WAY
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1254
Practice Address - Country:US
Practice Address - Phone:786-541-6008
Practice Address - Fax:754-206-3395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113523700Medicaid