Healthcare Provider Details

I. General information

NPI: 1871278184
Provider Name (Legal Business Name): RISE DC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 DECATUR PL NW
WASHINGTON DC
20008-1938
US

IV. Provider business mailing address

2121 DECATUR PL NW STE 10
WASHINGTON DC
20008-1943
US

V. Phone/Fax

Practice location:
  • Phone: 202-670-7656
  • Fax:
Mailing address:
  • Phone: 202-670-7656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MORGAN SMITH
Title or Position: OCCUPATIONAL THERAPIST & CO-FOUNDER
Credential: OTR/L
Phone: 412-965-5538