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General NPI Number Information
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NPI Number | 1043011653
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Entity Type | Organization
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Legal Business Name | RISING SKY SOLUTIONS
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 914 OAKMERE DR
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City | HARBOR CITY
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State | CA
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Zip | 90710-1531
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Country | US
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Telephone | 323-636-9485
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Fax |
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Provider Business Mailing Address
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Address Line | 914 OAKMERE DR
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City | HARBOR CITY
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State | CA
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Zip | 90710-1531
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Country | US
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Telephone | 323-636-9485
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SHALONDA Y JORDAN
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Credential |
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Telephone | 323-636-9485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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