Provider Demographics
NPI:1245969880
Name:RISE UP RECOVER, LLC
Entity type:Organization
Organization Name:RISE UP RECOVER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA MFT, LISAC CSAT
Authorized Official - Phone:602-698-8990
Mailing Address - Street 1:15655 W ROOSEVELT ST STE 223
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-9306
Mailing Address - Country:US
Mailing Address - Phone:602-698-8990
Mailing Address - Fax:
Practice Address - Street 1:15655 W ROOSEVELT ST STE 223
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-9306
Practice Address - Country:US
Practice Address - Phone:602-698-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1912317199OtherNPI
AZ1245969880OtherORGANIZATION NPI