Provider Demographics
NPI:1144851866
Name:RISE & SHINE DEVELOPMENTAL SERVICES
Entity type:Organization
Organization Name:RISE & SHINE DEVELOPMENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:REINHOLDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-616-0155
Mailing Address - Street 1:1317 DEL NORTE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-8600
Mailing Address - Country:US
Mailing Address - Phone:805-485-2000
Mailing Address - Fax:
Practice Address - Street 1:1317 DEL NORTE RD STE 105
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8600
Practice Address - Country:US
Practice Address - Phone:805-485-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy