Healthcare Provider Details

I. General information

NPI: 1033069596
Provider Name (Legal Business Name): RISE HEALTHCARE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 N MAIN ST STE 107
LOGAN UT
84321-4587
US

IV. Provider business mailing address

135 N MAIN ST STE 107
LOGAN UT
84321-4587
US

V. Phone/Fax

Practice location:
  • Phone: 435-554-8217
  • Fax:
Mailing address:
  • Phone: 435-554-8217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. KIRT HOGGAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 435-554-8217