MEDICARE: RISING HIGHER 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	106H00000X	Marriage & Family Therapist
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1629692058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISING HIGHER LLC

Provider Business Mailing Address
First Line	:	200 W CITY CENTER DR STE 302
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-1030
Country	:	US
Telephone Number	:	719-299-0540
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W CITY CENTER DR STE 302
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-1030
Country	:	US
Telephone Number	:	719-299-0540
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN MANN
Credential	:
Telephone Number	:	719-329-4718

Provider Enumeration Date	:	06/01/2020
Last Update Date	:	08/24/2020

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Directions to “RISING HIGHER LLC ” Practice Location

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