Provider Demographics
NPI:1467933267
Name:RESCUE 1 GLOBAL
Entity Type:Organization
Organization Name:RESCUE 1 GLOBAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF THERAPY AND PROGRAMMING
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WALSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-287-9198
Mailing Address - Street 1:6688 NOLENSVILLE ROAD
Mailing Address - Street 2:SUITE 108/167
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6688 NOLENSVILLE ROAD
Practice Address - Street 2:SUITE 108/167
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027
Practice Address - Country:US
Practice Address - Phone:615-348-7273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNI000000022237261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherNO PROVIDER IDENTIFIERS YET