Provider Demographics
NPI:1841756988
Name:A TIME TO RISE - COUNSELING & WELLNESS LLC
Entity type:Organization
Organization Name:A TIME TO RISE - COUNSELING & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR & SUD COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY-JO
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRBROTHER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:207-573-4722
Mailing Address - Street 1:12 ACME RD STE 207
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1546
Mailing Address - Country:US
Mailing Address - Phone:207-573-4722
Mailing Address - Fax:
Practice Address - Street 1:12 ACME RD STE 207
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1546
Practice Address - Country:US
Practice Address - Phone:207-573-4722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health