1558227157 NPI number — RISE AND ROOT BEHAVIORAL HEALTH SERVICES OF WASHINGTON STATE LLC

NPI Number: 1558227157
Health Care Provider/Practitioner: RISE AND ROOT BEHAVIORAL HEALTH SERVICES OF WASHINGTON STATE LLC

NPI Number : 1558227157 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558227157",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RISE AND ROOT BEHAVIORAL HEALTH SERVICES OF WASHINGTON STATE LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5900 100TH ST SW STE 16",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LAKEWOOD",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98499-2749",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "719-243-5097",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5900 100TH ST SW STE 16",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LAKEWOOD",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98499-2749",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "719-243-5097",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/29/2025",
    "LastUpdateDate": "12/29/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "REID",
    "AuthorizedOfficialFirstName": "MARQUITA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "EDD",
    "AuthorizedOfficialTelephoneNumber": "719-243-5097",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QR0405X",
          "TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}