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Organization

PHOENIX RISING COUNSELING L.L.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAYMI HARGROVE (LLMSW)
(616) 970-4661
Entity
Organization

Contact information

Practice address
2521 WOODLAKE RD SW APT 4, WYOMING, MI 49519-4712
(616) 970-4661
Mailing address
2521 WOODLAKE RD SW APT 4, WYOMING, MI 49519-4712

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary

Other

Enumeration date
05/16/2024
Last updated
05/16/2024
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