=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467300087
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | R.I.S.E FAMILY SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2026
-----------------------------------------------------
Last Update Date | 03/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9811 MALLARD DR STE 203
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-778-8835
-----------------------------------------------------
Fax | 301-778-0528
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9811 MALLARD DR STE 203
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-778-8835
-----------------------------------------------------
Fax | 301-778-0528
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | SHONNELL SHELTON
-----------------------------------------------------
Credential | LCSW-C
-----------------------------------------------------
Telephone | 240-918-0861
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------