Provider Demographics
NPI:1467723643
Name:MEN ON THE RISE INC
Entity Type:Organization
Organization Name:MEN ON THE RISE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-351-8798
Mailing Address - Street 1:6509 CHATTER ST
Mailing Address - Street 2:
Mailing Address - City:N.LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084
Mailing Address - Country:US
Mailing Address - Phone:702-351-8798
Mailing Address - Fax:
Practice Address - Street 1:6509 CHATTER ST
Practice Address - Street 2:
Practice Address - City:N.LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89084
Practice Address - Country:US
Practice Address - Phone:702-351-8798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty