Provider Demographics
NPI:1093538142
Name:RISE ABOVE EXCELLENCE LLC
Entity type:Organization
Organization Name:RISE ABOVE EXCELLENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLARICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHORTER-ERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-455-4243
Mailing Address - Street 1:11000 W MCNICHOLS RD STE 17&18
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2357
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11000 W MCNICHOLS RD STE 17&18
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-2357
Practice Address - Country:US
Practice Address - Phone:313-455-4243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care