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General NPI Number Information
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NPI Number | 1477470839
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Entity Type | Organization
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Legal Business Name | PHOENIX RISING THERAPY
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 6708 TAYLOR CIR OFC B
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City | MONTGOMERY
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State | AL
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Zip | 36117-3411
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Country | US
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Telephone | 334-769-3580
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Fax | 334-216-6360
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Provider Business Mailing Address
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Address Line | 6708 TAYLOR CIR OFC B
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City | MONTGOMERY
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State | AL
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Zip | 36117-3411
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Country | US
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Telephone | 334-769-3580
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Fax | 334-216-6360
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Authorized Official
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Title or Position | OWNER
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Name | LEIGH ANNE FAGIN
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Credential |
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Telephone | 334-769-3580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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