MEDICARE: RISE COMMUNITY HUB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1356209001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISE COMMUNITY HUB LLC

Provider Business Mailing Address
First Line	:	1500 E TROPICANA AVE STE 265
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-8317
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 E TROPICANA AVE STE 265
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-8317
Country	:	US
Telephone Number	:	725-232-1125
Fax Number	:

Authorized Official
Title or Position	:	MANGER
Name	:	SABRINA AVERY
Credential	:
Telephone Number	:	725-232-1125

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “RISE COMMUNITY HUB LLC ” Practice Location

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