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General NPI Number Information
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NPI Number | 1174399430
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Entity Type | Organization
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Legal Business Name | RISE RESOURCE CENTER
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Dates
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Enumeration Date | 11/28/2023
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 301 N WILLARD ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3650
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Country | US
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Telephone | 623-216-6996
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Fax |
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Provider Business Mailing Address
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Address Line | 301 N WILLARD ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3650
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Country | US
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Telephone | 623-216-6996
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS EMILY MARIE HOLLY
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Credential |
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Telephone | 623-297-2146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State |
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