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Organization
RISE ABOVE, LLC
Active
Organization
RISE ABOVE, LLC
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HUBERT NSONA NGABU I (OWNER)
(505) 261-7416
Entity
Organization
Contact information
Practice address
12744 TOMLINSON DR SE, 12744 TOMLINSON DR SE, ALBUQUERQUE, NM 87123-3716
(505) 261-7416
(505) 298-2858
Mailing address
12744 TOMLINSON DR SE, ALBUQUERQUE, NM 87123-3716
(505) 261-7416
(505) 298-2858
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78307716
—
NM
Enumeration date
01/20/2011
Last updated
01/20/2011
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