| Phoenix Rising Intervention Services Inc | |
|
690 S Lincoln Dr Troy MO 63379-2808 | |
| (636) 295-6672 | |
| Not Available |
| Full Name | Phoenix Rising Intervention Services Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 690 S Lincoln Dr, Troy, Missouri |
| Authorized Official Name and Position | Joyce Lynn Dubea (CEO) |
| Authorized Official Contact | 6362956672 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Rising Intervention Services Inc 140 Westborough Dr Troy MO 63379-4453 Ph: (636) 295-6672 | Phoenix Rising Intervention Services Inc 690 S Lincoln Dr Troy MO 63379-2808 Ph: (636) 295-6672 |
| NPI Number | 1134707854 |
|---|---|
| Provider Enumeration Date | 04/01/2021 |
| Last Update Date | 04/01/2021 |
| Certification Date | 04/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134707854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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