Provider Demographics
NPI:1396448387
Name:RISE BEYOND LLC
Entity type:Organization
Organization Name:RISE BEYOND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARIF
Authorized Official - Middle Name:A
Authorized Official - Last Name:JALIL
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:904-217-2787
Mailing Address - Street 1:2925 N 7TH ST LOT 11
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-1860
Mailing Address - Country:US
Mailing Address - Phone:904-673-4064
Mailing Address - Fax:
Practice Address - Street 1:2925 N 7TH ST LOT 11
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32084-1860
Practice Address - Country:US
Practice Address - Phone:904-673-4064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care