Provider Demographics
NPI:1467282285
Name:RISE UP TRANSITIONAL RESOURCES LLC
Entity type:Organization
Organization Name:RISE UP TRANSITIONAL RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-413-4891
Mailing Address - Street 1:70 SHADOWRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:618 HEMSATH RD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5919
Practice Address - Country:US
Practice Address - Phone:636-383-6959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit