Provider Demographics
NPI:1942773015
Name:RISE BEHAVIORAL SERVICES LLC
Entity type:Organization
Organization Name:RISE BEHAVIORAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONYELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:225-305-4542
Mailing Address - Street 1:PO BOX 1806
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-1806
Mailing Address - Country:US
Mailing Address - Phone:225-305-4542
Mailing Address - Fax:844-270-3049
Practice Address - Street 1:9305 MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-7441
Practice Address - Country:US
Practice Address - Phone:225-278-1020
Practice Address - Fax:844-270-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty