Provider Demographics
NPI:1053721688
Name:R.I.S.E., INC.
Entity type:Organization
Organization Name:R.I.S.E., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCAVOY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:207-783-7473
Mailing Address - Street 1:675 MAIN ST
Mailing Address - Street 2:SUITE 19
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5802
Mailing Address - Country:US
Mailing Address - Phone:207-783-7473
Mailing Address - Fax:207-783-7474
Practice Address - Street 1:675 MAIN ST
Practice Address - Street 2:SUITE 19
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5802
Practice Address - Country:US
Practice Address - Phone:207-783-7473
Practice Address - Fax:207-783-7474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2016-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care