MEDICARE: TO RISE UP THROUGH HELP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1154980654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TO RISE UP THROUGH HELP

Provider Business Mailing Address
First Line	:	4525 DEAN MARTIN DR UNIT 801
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-8109
Country	:	US
Telephone Number	:	832-588-8281
Fax Number	:

Provider Business Practice Location Address
First Line	:	4525 DEAN MARTIN DR UNIT 801
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-8109
Country	:	US
Telephone Number	:	832-588-8281
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JARRELL HOLMAN
Credential	:
Telephone Number	:	832-588-8281

Provider Enumeration Date	:	06/07/2019
Last Update Date	:	05/28/2020

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Directions to “TO RISE UP THROUGH HELP ” Practice Location

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