| Root & Rise, Llc | |
|
211 N Trent Ave Fayetteville AR 72701-4249 | |
| (864) 569-5113 | |
| Not Available |
| Full Name | Root & Rise, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 211 N Trent Ave, Fayetteville, Arkansas |
| Authorized Official Name and Position | Alicia Dawn Reeves (CEO) |
| Authorized Official Contact | 8645695113 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Root & Rise, Llc 211 N Trent Ave Fayetteville AR 72701-4249 Ph: (864) 569-5113 | Root & Rise, Llc 211 N Trent Ave Fayetteville AR 72701-4249 Ph: (864) 569-5113 |
| NPI Number | 1093428823 |
|---|---|
| Provider Enumeration Date | 12/26/2022 |
| Last Update Date | 12/26/2022 |
| Certification Date | 12/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093428823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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