Provider Demographics
NPI:1609489939
Name:THE ARISE SOCIETY
Entity Type:Organization
Organization Name:THE ARISE SOCIETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:VAUGHN
Authorized Official - Last Name:HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:385-222-1934
Mailing Address - Street 1:784 S RIVER RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84660-4712
Mailing Address - Country:US
Mailing Address - Phone:385-222-1934
Mailing Address - Fax:
Practice Address - Street 1:784 S RIVER RIDGE LN
Practice Address - Street 2:
Practice Address - City:SPANISH FORK
Practice Address - State:UT
Practice Address - Zip Code:84660-4712
Practice Address - Country:US
Practice Address - Phone:385-222-1934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT339436-3902OtherTHERAPEUTIC SUPPORT