Organization
PHOENIX RISING PNCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA BERNARD GAMBLE (SOLE MEMBER)
(262) 349-8560
Entity
Organization
Contact information
Practice address
423 W CENTER ST, MILWAUKEE, WI 53212-2724
(262) 349-8560
(414) 635-3157
Mailing address
423 W CENTER ST, MILWAUKEE, WI 53212-2724
(262) 349-8560
(414) 635-3157
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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