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General NPI Number Information
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NPI Number | 1326830993
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Entity Type | Organization
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Legal Business Name | PHOENIX ARISING THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 15924 FENKELL ST
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City | DETROIT
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State | MI
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Zip | 48227-1970
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Country | US
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Telephone | 313-248-9452
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Fax |
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Provider Business Mailing Address
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Address Line | 19135 ADDISON DR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2404
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Country | US
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Telephone | 248-945-2700
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANGELA F HILL-LEWIS
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Credential | MA, LPC, CADC, C-SAT
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Telephone | 248-945-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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