Native Rising of Arizona LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NATIVE RISING OF ARIZONA LLC

Practice address

1717 W Northern Ave Ste 200
Phoenix, AZ 85021-5478

Phone

(714) 933-6190

NPI assigned

Sep 14, 2022

Organization subpart

No

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

Authorized official

Name

Adebowale M Oke, ETC

Title

Managing Member

Phone

(714) 933-6190

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1417679648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 E SHEA BLVD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283348",
            "telephone_number": "714-933-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W NORTHERN AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850215478",
            "telephone_number": "714-933-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE RISING OF ARIZONA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-05",
        "status": "A",
        "authorized_official_last_name": "OKE",
        "authorized_official_first_name": "ADEBOWALE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "714-933-6190",
        "authorized_official_credential": "ETC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.