Healthcare Provider Details

I. General information

NPI: 1962844712
Provider Name (Legal Business Name): RISE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1358 W BUSINESS PARK DR
OREM UT
84058-2203
US

IV. Provider business mailing address

1358 W BUSINESS PARK DR
OREM UT
84058-2203
US

V. Phone/Fax

Practice location:
  • Phone: 801-717-2387
  • Fax:
Mailing address:
  • Phone: 801-717-2387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number2013PCAUT000596
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number2013PCAUT000596
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHERRIE STANTON
Title or Position: OPERATIONS SPECIALIST
Credential:
Phone: 801-717-2387