Organization
RISE UP LIVING HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASSANDRA ROBERT (OWNER)
(682) 301-2042
Entity
Organization
Contact information
Practice address
361 HEIRLOOM DR, FORT WORTH, TX 76134-3950
(682) 301-2042
Mailing address
361 HEIRLOOM DR, FORT WORTH, TX 76134-3950
(682) 301-2042
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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