MEDICARE: RYSE UP BEHAVIOR HEALTH SERVICES LLC

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	320800000X	Mental Illness Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1538800289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYSE UP BEHAVIOR HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	4939 W RAY RD STE 4231
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85226-2065
Country	:	US
Telephone Number	:	480-232-2516
Fax Number	:

Provider Business Practice Location Address
First Line	:	848 E GARY LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-6653
Country	:	US
Telephone Number	:	480-232-2516
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DEBBIE HARDY
Credential	:
Telephone Number	:	480-232-2516

Provider Enumeration Date	:	04/06/2022
Last Update Date	:	04/06/2022

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