Provider Demographics
NPI:1851170427
Name:RISE RECOVERY AND PERFORMANCE CENTER, PLLC
Entity Type:Organization
Organization Name:RISE RECOVERY AND PERFORMANCE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SACCUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:610-806-2055
Mailing Address - Street 1:4000 MASON LN APT 4112
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-5438
Mailing Address - Country:US
Mailing Address - Phone:412-605-7212
Mailing Address - Fax:
Practice Address - Street 1:3430 FAIRFIELD AVE S UNIT A
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1700
Practice Address - Country:US
Practice Address - Phone:610-806-2055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1508440538OtherNPI