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Organization
PHOENIX RISING BEHAVIORAL HEALTH LLC
Active
Organization
PHOENIX RISING BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVIE JEROME BOUYER II (OWNER)
(407) 534-0646
Entity
Organization
Contact information
Practice address
618 GILDAY CT, N LAS VEGAS, NV 89030-4059
(407) 534-0646
Mailing address
618 GILDAY CT, N LAS VEGAS, NV 89030-4059
(407) 534-0646
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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