Provider Demographics
NPI:1265294581
Name:RISE TRAUMA CENTER LLC
Entity type:Organization
Organization Name:RISE TRAUMA CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-256-6098
Mailing Address - Street 1:2380 W ARMADILLO ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-1205
Mailing Address - Country:US
Mailing Address - Phone:520-256-6098
Mailing Address - Fax:
Practice Address - Street 1:2380 W ARMADILLO ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-1205
Practice Address - Country:US
Practice Address - Phone:520-256-6098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty