Healthcare Provider Details

I. General information

NPI: 1427971605
Provider Name (Legal Business Name): AND I SHALL RISE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 14TH ST NE
MENOMONIE WI
54751-2036
US

IV. Provider business mailing address

209 14TH ST NE
MENOMONIE WI
54751-2036
US

V. Phone/Fax

Practice location:
  • Phone: 715-317-0726
  • Fax:
Mailing address:
  • Phone: 715-317-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICOLE MARSH
Title or Position: OWNER
Credential:
Phone: 715-317-0726