| Rise, Inc | |
|
3076 N Five Mile Rd Boise ID 83713-5215 | |
| (208) 376-4999 | |
| (208) 550-3264 |
| Full Name | Rise, Inc |
|---|---|
| Speciality | Voluntary or Charitable |
| Location | 3076 N Five Mile Rd, Boise, Idaho |
| Authorized Official Name and Position | Ken So (ACCOUNTS RECEIVABLE MANAGER) |
| Authorized Official Contact | 4802953327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rise, Inc Po Box 539 Orem UT 84059-0539 Ph: (801) 852-4581 | Rise, Inc 3076 N Five Mile Rd Boise ID 83713-5215 Ph: (208) 376-4999 |
| NPI Number | 1720049190 |
|---|---|
| Provider Enumeration Date | 03/28/2006 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Medicare PECOS PAC ID | 2365593795 |
|---|---|
| Medicare Enrollment ID | O20230519001565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720049190 | NPI | - | NPPES |
| Provider Name | Jenny Lee Doty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215360631 PECOS PAC ID: 5890080923 Enrollment ID: I20160829000231 |
| Provider Name | Toni Carles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144527607 PECOS PAC ID: 6406131531 Enrollment ID: I20170331001869 |
| Provider Name | Danielle B Pfost-banks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477759660 PECOS PAC ID: 6800982604 Enrollment ID: I20191008000734 |
| Provider Name | Elizabeth Ashlea Daffern |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861256422 PECOS PAC ID: 6305284472 Enrollment ID: I20240409001851 |
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