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General NPI Number Information
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NPI Number | 1861313280
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Entity Type | Organization
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Legal Business Name | SKYRISE WELLNESS
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 618 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19133-2227
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Country | US
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Telephone | 267-225-8083
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Fax | 215-610-8879
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Provider Business Mailing Address
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Address Line | 618 W LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19133-2227
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Country | US
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Telephone | 267-225-8083
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Fax | 215-610-8879
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Authorized Official
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Title or Position | OWNER
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Name | ANTONIO CARABALLO
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Credential | PMHNP-BC
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Telephone | 267-973-2858
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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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