Organization
RISING STAR BEHAVIOR HEALTH LLC
Active
Other names
RISING STAR BEHAVIOR HEALTH LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMON ADDEI (ADMINISTRATOR)
(602) 814-4693
Entity
Organization
Contact information
Practice address
546 E PASTURE CANYON DR, SAN TAN VALLEY, AZ 85143-5814
(720) 499-8868
(480) 452-0828
Mailing address
546 E PASTURE CANYON DR, SAN TAN VALLEY, AZ 85143-5814
(602) 814-4693
(480) 452-0828
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BH7360
—
AZ
Enumeration date
03/09/2022
Last updated
06/17/2022
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