Healthcare Provider Details

I. General information

NPI: 1649014929
Provider Name (Legal Business Name): RISE ABOVE ENTERPRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 TIMBERLOCH PL STE 500
SPRING TX
77380-1375
US

IV. Provider business mailing address

2001 TIMBERLOCH PL STE 500
SPRING TX
77380-1375
US

V. Phone/Fax

Practice location:
  • Phone: 346-672-4630
  • Fax:
Mailing address:
  • Phone: 346-672-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: LAURENCE GRIGSBY II
Title or Position: OWNER
Credential:
Phone: 346-672-4630