Provider Demographics
NPI:1508548017
Name:EARLY RISE LLP
Entity Type:Organization
Organization Name:EARLY RISE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:TAFADZWA
Authorized Official - Middle Name:ANTONY
Authorized Official - Last Name:CHIDEMBO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:302-233-1348
Mailing Address - Street 1:5330 GREAT OAK WAY APT B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-4508
Mailing Address - Country:US
Mailing Address - Phone:302-233-1348
Mailing Address - Fax:
Practice Address - Street 1:5330 GREAT OAK WAY APT B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-4508
Practice Address - Country:US
Practice Address - Phone:302-233-1348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care