Healthcare Provider Details
I. General information
NPI: 1063293918
Provider Name (Legal Business Name): RISE SENIOR AND FAMILY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/06/2023
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1331 N STEWART AVE STE A
SPRINGFIELD MO
65802-2239
US
IV. Provider business mailing address
1331 N STEWART AVE STE A
SPRINGFIELD MO
65802-2239
US
V. Phone/Fax
- Phone: 417-943-4140
- Fax:
- Phone: 417-943-4140
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SAMANTHA
TROUTMAN
Title or Position: FOUNDER AND CEO
Credential:
Phone: 417-593-2789