Healthcare Provider Details

I. General information

NPI: 1881532364
Provider Name (Legal Business Name): RISE UP HEALTH AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 TROVATO ST STE 101
BRIDGEPORT WV
26330-7285
US

IV. Provider business mailing address

27 TROVATO ST STE 101
BRIDGEPORT WV
26330-7285
US

V. Phone/Fax

Practice location:
  • Phone: 304-290-8134
  • Fax:
Mailing address:
  • Phone: 304-290-8134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number State

VIII. Authorized Official

Name: DAISY LYNN CULVERHOUSE-PERRY
Title or Position: OWNER, APRN
Credential: APRN
Phone: 304-290-8134