Provider Demographics
NPI:1114899424
Name:FATHERS RISE TOGETHER
Entity type:Organization
Organization Name:FATHERS RISE TOGETHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHAQUANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCENTYRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-461-1722
Mailing Address - Street 1:2527 BROKEN BOW DR
Mailing Address - Street 2:
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-5515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2527 BROKEN BOW DR
Practice Address - Street 2:
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-5515
Practice Address - Country:US
Practice Address - Phone:218-390-9204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management