Provider Demographics
NPI:1750850764
Name:RISE CAREER SERVICES & LEADERSHIP DEVELOPMENT, LLC
Entity Type:Organization
Organization Name:RISE CAREER SERVICES & LEADERSHIP DEVELOPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONYELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-305-4542
Mailing Address - Street 1:6382 MALLARD CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-8344
Mailing Address - Country:US
Mailing Address - Phone:225-305-4542
Mailing Address - Fax:
Practice Address - Street 1:5145 MAIN ST STE I
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-3900
Practice Address - Country:US
Practice Address - Phone:225-245-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty