Rise Luxury Rehab, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

RISE LUXURY REHAB, LLC

Doing business as

Rise in Malibu

Practice address

1950 Rocking Horse Dr
Simi Valley, CA 93065-5906

Phone

(424) 313-5108

Fax

(310) 807-4379

NPI assigned

Dec 4, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Patrick Mitchell

Title

Ceo

Phone

(310) 807-4379

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rise in Malibu Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1275003030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 WESTWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 ROCKING HORSE DR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930655906",
            "telephone_number": "424-313-5108",
            "fax_number": "310-807-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE LUXURY REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-807-4379"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE NUMBER",
            "identifier": "560011AP",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rise in Malibu",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Riley Stai, RD
• Laura L Riley, R.N.
• Clemson Rino Fernandez Rillera, PT
• Jessica Jeannette Rios
• Rise & Thrive Growth Lab
• Pamela A. Riss, LMFT
• Rite Aid Pharmacy
• Rite Aid Pharmacy
• Rite Aid Pharmacy Store# 05786
• Jose Rivera

• Substance Abuse Rehabilitation Facility in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.