Provider Demographics
NPI:1457964025
Name:RISE UP RESILIENCY CENTER, LLC
Entity type:Organization
Organization Name:RISE UP RESILIENCY CENTER, LLC
Other - Org Name:<UNAVAIL>
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, LCPC
Authorized Official - Phone:888-913-7872
Mailing Address - Street 1:601 N MUR LEN RD STE 12A
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-5425
Mailing Address - Country:US
Mailing Address - Phone:888-913-7872
Mailing Address - Fax:913-273-4820
Practice Address - Street 1:601 N MUR LEN RD STE 12A
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-5425
Practice Address - Country:US
Practice Address - Phone:888-913-7872
Practice Address - Fax:913-273-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS30004853480001Medicaid