Provider Demographics
NPI:1417712407
Name:RISE THERAPEUTIC SOLUTIONS
Entity Type:Organization
Organization Name:RISE THERAPEUTIC SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BREE
Authorized Official - Middle Name:JENENE
Authorized Official - Last Name:AUSTIN-ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:616-346-8019
Mailing Address - Street 1:963 SAGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-5390
Mailing Address - Country:US
Mailing Address - Phone:616-346-8019
Mailing Address - Fax:
Practice Address - Street 1:665 136TH AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-1897
Practice Address - Country:US
Practice Address - Phone:616-346-8019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty