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NPI Code Detail

MEDICARE: RISE UP REHAB, LLC

MEDICARE: RISE UP REHAB, 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
1225100000XPhysical Therapist
2225X00000XOccupational Therapist
3235Z00000XSpeech-Language Pathologist
4261QR0401XComprehensive Outpatient Rehabilitation Facility (CORF)
5261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1962054858
Entity Type Code : Organization
Provider Name (Legal Business Name) : RISE UP REHAB, LLC
Provider Business Mailing Address
First Line : 16400 BLANCO RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-1902
Country : US
Telephone Number : 210-724-0505
Fax Number : 210-699-7995
Provider Business Practice Location Address
First Line : 16400 BLANCO RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-1902
Country : US
Telephone Number : 210-724-0505
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TIFFANY D GOLD
Credential :
Telephone Number : 210-724-0505
Provider Enumeration Date : 07/11/2019
Last Update Date : 07/10/2025

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