Healthcare Provider Details

I. General information

NPI: 1295659092
Provider Name (Legal Business Name): RISE AND REACH BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20496 E VIA DE ARBOLES
QUEEN CREEK AZ
85142-5338
US

IV. Provider business mailing address

3101 N CENTRAL AVE STE 183
PHOENIX AZ
85012-3616
US

V. Phone/Fax

Practice location:
  • Phone: 480-399-4511
  • Fax:
Mailing address:
  • Phone: 480-399-4511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JORDAN FICKERT
Title or Position: OWNER
Credential:
Phone: 480-399-4511