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General NPI Number Information
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NPI Number | 1588402150
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Entity Type | Organization
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Legal Business Name | ARISE WELLNESS, INC.
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Dates
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Enumeration Date | 07/18/2024
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 9233 RESEARCH DR
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City | IRVINE
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State | CA
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Zip | 92618-4293
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Country | US
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Telephone | 844-932-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 9233 RESEARCH DR
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City | IRVINE
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State | CA
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Zip | 92618-4293
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Country | US
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Telephone | 844-932-7473
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. GOLNAZ AGAHI
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Credential | DSW, LCSW, MPH
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Telephone | 844-932-7473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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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 | 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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