Provider Demographics
NPI:1023486602
Name:RAISE THE BAR THERAPY SERVICES
Entity type:Organization
Organization Name:RAISE THE BAR THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BIELE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:910-685-4505
Mailing Address - Street 1:508 NAVIGATOR DR
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:NC
Mailing Address - Zip Code:28443-3704
Mailing Address - Country:US
Mailing Address - Phone:910-685-4505
Mailing Address - Fax:910-939-1519
Practice Address - Street 1:18676 US HIGHWAY 17 N
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:NC
Practice Address - Zip Code:28443-3227
Practice Address - Country:US
Practice Address - Phone:910-821-1700
Practice Address - Fax:910-939-1519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-12
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6483261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty