Organization
PHOENIX RISING BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVIE JEROME BOUYER II (OWNER)
(407) 534-0646
Entity
Organization
Contact information
Practice address
618 GILDAY CT, N LAS VEGAS, NV 89030-4059
(407) 534-0646
Mailing address
618 GILDAY CT, N LAS VEGAS, NV 89030-4059
(407) 534-0646
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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