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Organization
INSPIRE TO RISE, INC.
Active
Organization
INSPIRE TO RISE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AIDA PANTALEON SEERAJ (CEO/OWNER)
(844) 937-4731
Entity
Organization
Contact information
Practice address
5927 OLD TIMUQUANA RD, JACKSONVILLE, FL 32210
(844) 937-4731
(904) 490-8394
Mailing address
5927 OLD TIMUQUANA RD, JACKSONVILLE, FL 32210-7889
(844) 937-4731
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101215400
—
FL
01
—
LIC-1047530
DCF SAMH LICENSE FOR CASE MANAGEMENT
FL
01
—
LIC-1047531
DCF SAMH LICENSE FOR OUTPATIENT TREATMENT
FL
01
—
LIC-1047532
DCF SAMH LICENSE FOR GENERAL INTERVENTION
FL
Enumeration date
09/13/2018
Last updated
09/04/2021
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