Provider Demographics
NPI:1447607817
Name:RISING GROUND. INC
Entity Type:Organization
Organization Name:RISING GROUND. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:DREISLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-375-8700
Mailing Address - Street 1:463 HAWTHORNE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-3441
Mailing Address - Country:US
Mailing Address - Phone:914-375-8703
Mailing Address - Fax:914-963-6586
Practice Address - Street 1:1529 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2502
Practice Address - Country:US
Practice Address - Phone:718-794-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X
251S00000X, 261QM0801X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02495141Medicaid
NY00328074Medicaid