Organization
RISE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WENDELL BELLAH (EXECUTIVE DIRECTOR)
(801) 676-8912
Entity
Organization
Contact information
Practice address
6150 S REDWOOD RD, TAYLORSVILLE, UT 84123-5333
(801) 676-8912
Mailing address
6150 S REDWOOD RD, TAYLORSVILLE, UT 84123-5333
(801) 676-8912
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
19584
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720049190
—
UT
Enumeration date
05/29/2013
Last updated
05/29/2013
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