Organization
PHOENIX RISING WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN MORRIS (OWNER)
(414) 436-9918
Entity
Organization
Contact information
Practice address
10425 W NORTH AVE STE 311, MILWAUKEE, WI 53226-2400
(414) 436-9918
Mailing address
10425 W NORTH AVE STE 311, MILWAUKEE, WI 53226-2400
(414) 436-9918
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/07/2021
Last updated
06/29/2023
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