| Rising Phoenix Behavioral Services | |
|
558 Camino Mercado Arroyo Grande CA 93420-1815 | |
| (805) 941-1025 | |
| (805) 941-1026 |
| Full Name | Rising Phoenix Behavioral Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 558 Camino Mercado, Arroyo Grande, California |
| Authorized Official Name and Position | Lauren Meredith Cook (OWNER) |
| Authorized Official Contact | 8054406471 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Phoenix Behavioral Services Po Box 331 Grover Beach CA 93483-0331 Ph: (805) 941-1025 | Rising Phoenix Behavioral Services 558 Camino Mercado Arroyo Grande CA 93420-1815 Ph: (805) 941-1025 |
| NPI Number | 1518570555 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 12/12/2024 |
| Certification Date | 12/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518570555 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (NU) | Primary |
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