Healthcare Provider Details

I. General information

NPI: 1700642220
Provider Name (Legal Business Name): HOPE RISING WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 S 1000 E
ST GEORGE UT
84790-5555
US

IV. Provider business mailing address

671 S 1000 E
ST GEORGE UT
84790-5555
US

V. Phone/Fax

Practice location:
  • Phone: 435-215-7533
  • Fax:
Mailing address:
  • Phone: 435-215-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SCOTT MAYFIELD
Title or Position: CEO
Credential:
Phone: 435-669-4024