Provider Demographics
NPI:1457964025
Name:RISE UP RESILIENCY CENTER LLC
Entity Type:Organization
Organization Name:RISE UP RESILIENCY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SADE
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:GARR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:913-735-0281
Mailing Address - Street 1:8908 HASKINS ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-3421
Mailing Address - Country:US
Mailing Address - Phone:913-333-9939
Mailing Address - Fax:
Practice Address - Street 1:8645 COLLEGE BLVD STE 125
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66210-2034
Practice Address - Country:US
Practice Address - Phone:913-735-0281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)