MEDICARE: PHOENIX RISES HEALTHCARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	106S00000X	Behavior Technician
2	163WH0200X	Home Health Registered Nurse
3	163WH1000X	Hospice Registered Nurse
4	163WW0000X	Wound Care Registered Nurse
5	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1811832215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHOENIX RISES HEALTHCARE INC

Provider Business Mailing Address
First Line	:	1038 CASTING SPRINGS WAY
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-7962
Country	:	US
Telephone Number	:	832-216-5995
Fax Number	:

Provider Business Practice Location Address
First Line	:	1038 CASTING SPRINGS WAY
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-7962
Country	:	US
Telephone Number	:	832-216-5995
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. TONIKA N WASHINGTON
Credential	:	CNA
Telephone Number	:	832-216-5995

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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