Healthcare Provider Details

I. General information

NPI: 1043149628
Provider Name (Legal Business Name): RISE & FLOURISH ABA THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 TOWN CENTER BLVD STE 205
FLEMING ISLAND FL
32003-3359
US

IV. Provider business mailing address

1845 TOWN CENTER BLVD STE 205
FLEMING ISLAND FL
32003-3359
US

V. Phone/Fax

Practice location:
  • Phone: 904-946-5404
  • Fax:
Mailing address:
  • Phone: 904-946-5404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JANNAH FIELDS
Title or Position: AUTHORIZED OFFICIAL
Credential: MA, BCBA
Phone: 904-236-1143