Provider Demographics
NPI:1952073900
Name:NORTHRISE PSYCHIATRIC AND ADDICTION MEDICINE
Entity Type:Organization
Organization Name:NORTHRISE PSYCHIATRIC AND ADDICTION MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIMONU
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:404-819-3344
Mailing Address - Street 1:105 WESTPARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-3174
Mailing Address - Country:US
Mailing Address - Phone:706-850-0741
Mailing Address - Fax:
Practice Address - Street 1:105 WESTPARK DR STE A
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3174
Practice Address - Country:US
Practice Address - Phone:706-850-0741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)