Provider Demographics
NPI:1568183036
Name:COMMUNITY RISES LLC
Entity Type:Organization
Organization Name:COMMUNITY RISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIGHBORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-431-0854
Mailing Address - Street 1:2820 N PINAL AVE STE 12NO243
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-7918
Mailing Address - Country:US
Mailing Address - Phone:520-431-0854
Mailing Address - Fax:
Practice Address - Street 1:115 E 1ST ST # B
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-5201
Practice Address - Country:US
Practice Address - Phone:520-431-0854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health