Provider Demographics
NPI:1932882545
Name:RISE HOME SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:RISE HOME SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-631-1545
Mailing Address - Street 1:931 E ALFRED ST
Mailing Address - Street 2:
Mailing Address - City:TAVARES
Mailing Address - State:FL
Mailing Address - Zip Code:32778-3401
Mailing Address - Country:US
Mailing Address - Phone:352-434-0475
Mailing Address - Fax:
Practice Address - Street 1:931 E ALFRED ST
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3401
Practice Address - Country:US
Practice Address - Phone:352-434-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care