| Rizing Starz,llc | |
|
31c South Jefferson St Petersburg VA 23803-4331 | |
| (804) 926-5268 | |
| Not Available |
| Full Name | Rizing Starz,llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 31c South Jefferson St, Petersburg, Virginia |
| Authorized Official Name and Position | Deseree Bolere (OWNER) |
| Authorized Official Contact | 8049265268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rizing Starz,llc 31c South Jefferson St Petersburg VA 23803-4331 Ph: (804) 926-5268 | Rizing Starz,llc 31c South Jefferson St Petersburg VA 23803-4331 Ph: (804) 926-5268 |
| NPI Number | 1053671461 |
|---|---|
| Provider Enumeration Date | 05/18/2012 |
| Last Update Date | 05/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053671461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Secondary |
| 251B00000X | Case Management | () | Secondary |
| 251S00000X | Community/behavioral Health | () | Primary |
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