Phoenix Rising Behavioral Healthcare and Recovery, Inc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

573 Issued in OH

Legal business name

PHOENIX RISING BEHAVIORAL HEALTHCARE AND RECOVERY, INC

Practice address

1930 Fremont PL SW
Canton, OH 44706-1551

Phone

(330) 455-5950

NPI assigned

Mar 13, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Lisa K Grubbs, LPCC

Title

Executive Director

Phone

(330) 455-5950

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Phoenix Rising Behavioral Healthcare3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Phoenix Rising Behavioral Healthcare and Recovery Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Canton, OH
  • NPI 1891737292
  NPD tax ID
• Phoenix Rising Behavioral Healthcare and Recovery, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Canton, OH
  • NPI 1710238613
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joann Yelichek, LPCC

  • Mental Health Counselor
  • Canton, OH
  • NPI 1336319409
  NPD (past)

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

{
    "created_epoch": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1154592525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 FREMONT PL SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447061551",
            "telephone_number": "330-455-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 FREMONT PL SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447061551",
            "telephone_number": "330-455-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING BEHAVIORAL HEALTHCARE AND RECOVERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "GRUBBS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-455-5950",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "OH",
            "license": "573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2625985",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samyha Phillips
• Shane M Phillips, PHARMD, RPH
• Tristan Daniel Phillips
• Phoenix Dermatology LTD
• Phoenix Rising Behavioral Healthcare and Recovery Inc
• Phoenix Rising Behavioral Healthcare and Recovery, Inc
• Kiran Phuloria, DO
• Physical Therapy Works, Inc.
• Physician Management Services of Ohio II, LLC
• Physician'S MRI Institute, LLC

• Non-Pharmacy Dispensing Site in Canton, OH
• Providers in Canton, OH by specialty
• Non-Pharmacy Dispensing Site in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; 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.