Healthcare Provider Details

I. General information

NPI: 1790611176
Provider Name (Legal Business Name): RISE AGAIN REHAB INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15136 LASSEN ST
MISSION HILLS CA
91345-3040
US

IV. Provider business mailing address

15136 LASSEN ST
MISSION HILLS CA
91345-3040
US

V. Phone/Fax

Practice location:
  • Phone: 818-422-4004
  • Fax:
Mailing address:
  • Phone:
  • 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: MANNE OGANYAN
Title or Position: CONSULTANT
Credential:
Phone: 818-422-4004