| Phoenix Rising Behavioral Health, Llc | |
|
120 Village Cir Senoia GA 30276-3374 | |
| (470) 447-2129 | |
| (470) 447-2139 |
| Full Name | Phoenix Rising Behavioral Health, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 120 Village Cir, Senoia, Georgia |
| Authorized Official Name and Position | Samantha Anni Skurja (OWNER) |
| Authorized Official Contact | 4704472129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Rising Behavioral Health, Llc 6855 Highway 16 Ste 101 Senoia GA 30276-0017 Ph: (470) 447-2129 | Phoenix Rising Behavioral Health, Llc 120 Village Cir Senoia GA 30276-3374 Ph: (470) 447-2129 |
| NPI Number | 1770163990 |
|---|---|
| Provider Enumeration Date | 04/12/2021 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770163990 | NPI | - | NPPES |
| 003250580A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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