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Organization
PHOENIX RISING ADDCITION CENTER INC.
Active
Organization
PHOENIX RISING ADDCITION CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN KANEAIAKALA III LAADC (OWNER)
(949) 463-8381
Entity
Organization
Contact information
Practice address
26072 MERIT CIR STE 104, LAGUNA HILLS, CA 92653-7015
(949) 463-8381
Mailing address
18 PIARA ST, RANCHO MISSION VIEJO, CA 92694-1821
(949) 463-8381
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/02/2019
Last updated
10/02/2019
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