Organization
PHOENIXRISELLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHOENIX D EVANS SR. (CEO)
(252) 316-5834
Entity
Organization
Contact information
Practice address
3100 CLEERE CT, GREENVILLE, NC 27858-5679
(252) 316-5834
Mailing address
3100 CLEERE CT, GREENVILLE, NC 27858-5679
(252) 316-5834
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/06/2024
Last updated
06/11/2024
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