# PHOENIXRISELLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588405047
- **Authorized official:** MR. PHOENIX D EVANS SR. (CEO)
- **Authorized official phone:** (252) 316-5834

## Contact information

- **Practice address:** 3100 CLEERE CT, GREENVILLE, NC 27858-5679
- **Practice address phone:** (252) 316-5834
- **Mailing address:** 3100 CLEERE CT, GREENVILLE, NC 27858-5679
- **Mailing address phone:** (252) 316-5834

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 06/06/2024
- **Last updated:** 06/11/2024