| Phoenix Rising Addcition Center Inc. | |
|
26072 Merit Cir Ste 104 Laguna Hills CA 92653-7015 | |
| (949) 463-8381 | |
| Not Available |
| Full Name | Phoenix Rising Addcition Center Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 26072 Merit Cir Ste 104, Laguna Hills, California |
| Authorized Official Name and Position | Benjamin Kaneaiakala (OWNER) |
| Authorized Official Contact | 9494638381 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Rising Addcition Center Inc. 18 Piara St Rancho Mission Viejo CA 92694-1821 Ph: (949) 463-8381 | Phoenix Rising Addcition Center Inc. 26072 Merit Cir Ste 104 Laguna Hills CA 92653-7015 Ph: (949) 463-8381 |
| NPI Number | 1144861972 |
|---|---|
| Provider Enumeration Date | 10/02/2019 |
| Last Update Date | 10/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144861972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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