Provider Demographics
NPI:1619405693
Name:TEMPLAR RISING LLC
Entity Type:Organization
Organization Name:TEMPLAR RISING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HOTSE
Authorized Official - Middle Name:BART
Authorized Official - Last Name:LANGERAAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-909-0540
Mailing Address - Street 1:275 COMMERCIAL BLVD.
Mailing Address - Street 2:SUITE #200
Mailing Address - City:LAUDERDALE BY THE SEA
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-909-0540
Mailing Address - Fax:954-368-7405
Practice Address - Street 1:275 COMMERCIAL BLVD.
Practice Address - Street 2:SUITE #200
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-909-0540
Practice Address - Fax:954-368-7405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty