Healthcare Provider Details

I. General information

NPI: 1255258612
Provider Name (Legal Business Name): RISE RECOVERY PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 W WALATOWA ST
LAVEEN AZ
85339-1316
US

IV. Provider business mailing address

5420 W WALATOWA ST
LAVEEN AZ
85339-1316
US

V. Phone/Fax

Practice location:
  • Phone: 480-352-2871
  • Fax:
Mailing address:
  • Phone: 480-352-2871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: EZRA NAPOLEON TUMUHIRWE
Title or Position: MANAGING MEMBER
Credential:
Phone: 480-352-2871