Phoenix Rising Behavioral Health Care Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHOENIX RISING BEHAVIORAL HEALTH CARE SERVICES, LLC

Practice address

92 Argonaut Ste 170
Aliso Viejo, CA 92656-4130

Phone

(949) 463-8381

NPI assigned

Nov 10, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Benjamin Kaainoa Kaneaiakala III, MBA, LAADC

Title

Co-Owner

Phone

(949) 463-8381

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563148800000",
    "number": "1124491360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PIARA ST",
            "city": "RANCHO MISSION VIEJO",
            "state": "CA",
            "postal_code": "926941821",
            "telephone_number": "949-463-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 ARGONAUT STE 170",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926564130",
            "telephone_number": "949-463-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING BEHAVIORAL HEALTH CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2019-07-15",
        "status": "A",
        "authorized_official_last_name": "KANEAIAKALA",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "KAAINOA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "949-463-8381",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MBA, LAADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Jungwirth,M.D.,Inc
• Phaite Behavioral Health Care Services
• Elise Pham, DMD
• Peter Minh Phan, MD
• Sarah Kim Phan
• Andrea Pixley
• Gisella Xianne Plaza, RPT
• Linda Diane Pongracz, LVN
• Roni Portillo, MFTI
• Ariana Pourbabak, PHARMD

• Community/Behavioral Health Agency in Aliso Viejo, CA
• Providers in Aliso Viejo, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.