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General NPI Number Information
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NPI Number | 1790613115
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Entity Type | Organization
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Legal Business Name | RISE RESOURCE CENTER LLC
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 6955 N DURANGO DR
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City | LAS VEGAS
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State | NV
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Zip | 89149-4485
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Country | US
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Telephone | 702-885-1441
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Fax |
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Provider Business Mailing Address
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Address Line | 6955 N DURANGO DR 1115-274
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City | LAS VEGAS
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State | NV
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Zip | 89149-4485
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AMIYNA WASHINGTON
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Credential |
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Telephone | 702-885-1441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QP0002X
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Taxonomy Name | Physician Nutrition Specialist (Family Medicine)
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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