MEDICARE: RISE AND RESTORE COUNSELING CENTER LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1528944394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISE AND RESTORE COUNSELING CENTER LLC

Provider Business Mailing Address
First Line	:	14611 TWILIGHT KNOLL TRL
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-7825
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3707 CYPRESS CREEK PKWY STE 200F
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3526
Country	:	US
Telephone Number	:	832-641-5338
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JEFFREY ASHLEY
Credential	:
Telephone Number	:	832-641-5338

Provider Enumeration Date	:	08/15/2025
Last Update Date	:	08/15/2025

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