Healthcare Provider Details
I. General information
NPI: 1043129398
Provider Name (Legal Business Name): RISE RESTORING INDEPENDENCE, STABILITY AND EMPWERMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
150 W OCEAN BLVD APT 1221
LONG BEACH CA
90802-4796
US
IV. Provider business mailing address
150 W OCEAN BLVD APT 1221
LONG BEACH CA
90802-4796
US
V. Phone/Fax
- Phone: 562-276-5034
- Fax:
- Phone: 562-276-5034
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
JASMEEN
PADILLA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 562-276-5034