Provider Demographics
NPI:1346864147
Name:RISING YOUTH LLC
Entity Type:Organization
Organization Name:RISING YOUTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-232-8600
Mailing Address - Street 1:501 S 48TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-2313
Mailing Address - Country:US
Mailing Address - Phone:480-232-8600
Mailing Address - Fax:480-444-1452
Practice Address - Street 1:5948 E FOUNTAIN CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85205-5513
Practice Address - Country:US
Practice Address - Phone:480-232-8600
Practice Address - Fax:480-444-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health