Provider Demographics
NPI:1346772803
Name:RISE UP THERAPY
Entity Type:Organization
Organization Name:RISE UP THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-366-2700
Mailing Address - Street 1:1726 W RIO VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1119
Mailing Address - Country:US
Mailing Address - Phone:813-810-0692
Mailing Address - Fax:866-201-2279
Practice Address - Street 1:1726 W RIO VISTA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1119
Practice Address - Country:US
Practice Address - Phone:813-810-0692
Practice Address - Fax:866-201-2279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty