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General NPI Number Information
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NPI Number | 1952191223
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Entity Type | Organization
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Legal Business Name | RISE AND THRIVE SOLUTIONS LLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 1013 N 5TH AVE NE STE 4
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City | ROME
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State | GA
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Zip | 30165-2664
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Country | US
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Telephone | 706-225-9565
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Fax |
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Provider Business Mailing Address
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Address Line | 4384 HIGHWAY 382 W
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City | ELLIJAY
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State | GA
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Zip | 30540-6978
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Country | US
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Telephone | 706-225-9565
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. AMY MARIE HERZOG
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Credential | PMHNP-BC
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Telephone | 706-225-9565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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