Provider Demographics
NPI:1316590979
Name:RISE BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:RISE BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:R
Authorized Official - Last Name:PITTSINGER
Authorized Official - Suffix:JR
Authorized Official - Credentials:BCBA, LABA
Authorized Official - Phone:413-331-9528
Mailing Address - Street 1:180 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:INDIAN ORCHARD
Mailing Address - State:MA
Mailing Address - Zip Code:01151-1465
Mailing Address - Country:US
Mailing Address - Phone:413-331-9528
Mailing Address - Fax:
Practice Address - Street 1:180 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:INDIAN ORCHARD
Practice Address - State:MA
Practice Address - Zip Code:01151-1465
Practice Address - Country:US
Practice Address - Phone:413-331-9528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care