Provider Demographics
NPI:1538704770
Name:RISE SERVICES LLC
Entity Type:Organization
Organization Name:RISE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-418-1020
Mailing Address - Street 1:11357 NUCKOIS ROAD
Mailing Address - Street 2:SUITE 2043
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059
Mailing Address - Country:US
Mailing Address - Phone:540-418-1020
Mailing Address - Fax:703-214-8239
Practice Address - Street 1:11357 NUCKOIS ROAD
Practice Address - Street 2:SUITE 2043
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059
Practice Address - Country:US
Practice Address - Phone:540-418-1020
Practice Address - Fax:703-214-8239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health