Organization
PHOENIX RISING BEHAVIORAL HEALTHCARE AND RECOVERY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA K GRUBBS LPCC (EXECUTIVE DIRECTOR)
(330) 455-5950
Entity
Organization
Contact information
Practice address
1930 FREMONT PL SW, CANTON, OH 44706-1551
(330) 455-5950
Mailing address
1930 FREMONT PL SW, CANTON, OH 44706-1551
(330) 455-5950
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
573
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2625985
—
OH
Enumeration date
03/13/2008
Last updated
03/13/2008
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