Healthcare Provider Details

I. General information

NPI: 1467300087
Provider Name (Legal Business Name): R.I.S.E FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9811 MALLARD DR STE 203
LAUREL MD
20708-3199
US

IV. Provider business mailing address

9811 MALLARD DR STE 203
LAUREL MD
20708-3199
US

V. Phone/Fax

Practice location:
  • Phone: 301-778-8835
  • Fax: 301-778-0528
Mailing address:
  • Phone: 301-778-8835
  • Fax: 301-778-0528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHONNELL SHELTON
Title or Position: CEO/OWNER
Credential: LCSW-C
Phone: 240-918-0861