Organization
RISING PHOENIX NEIGHBORHOOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE REED (STATUTORY AGENT)
(480) 447-5588
Entity
Organization
Contact information
Practice address
202 E EARLL DR UNIT 360-35, PHOENIX, AZ 85012-2634
(480) 447-5588
Mailing address
202 E EARLL DR UNIT 360-35, PHOENIX, AZ 85012-2634
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
—
—
Other
Enumeration date
07/06/2020
Last updated
07/06/2020
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