Provider Demographics
NPI:1023808151
Name:RISE HOLISTIC WELLNESS
Entity type:Organization
Organization Name:RISE HOLISTIC WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:KRAAI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:720-672-5040
Mailing Address - Street 1:2103 56TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1068
Mailing Address - Country:US
Mailing Address - Phone:720-672-5040
Mailing Address - Fax:
Practice Address - Street 1:2103 56TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1068
Practice Address - Country:US
Practice Address - Phone:720-672-5040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)