Phoenix Rising Addcition Center Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

PHOENIX RISING ADDCITION CENTER INC.

Practice address

26072 Merit Cir Ste 104
Laguna Hills, CA 92653-7015

Phone

(949) 463-8381

NPI assigned

Oct 2, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Benjamin Kaneaiakala III, LAADC

Title

Owner

Phone

(949) 463-8381

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569974400000",
    "number": "1144861972",
    "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": "26072 MERIT CIR STE 104",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926537015",
            "telephone_number": "949-463-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING ADDCITION CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A",
        "authorized_official_last_name": "KANEAIAKALA",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-463-8381",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "LAADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Laguna Hills, CA
• Providers in Laguna Hills, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.