Phoenix Rising Behavioral Health LLC
NPI #1912559584 in N Las Vegas, Nevada
Provider Information
- NPI Number
- 1912559584
- Entity Type
- Organization
- Organization Name
- Phoenix Rising Behavioral Health LLC
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Jul 12, 2019
- Last Updated
- Jul 12, 2019
Practice Location
- Address
- 618 GILDAY CT
- City
- N Las Vegas
- State
- Nevada
- ZIP Code
- 89030-4059
- Phone
- (407) 534-0646
Authorized Official
- Name
- MR. STEVIE JEROME BOUYER II
- Title
- OWNER
- Phone
- (407) 534-0646
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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