Provider Demographics
NPI:1477685857
Name:RISING PHOENIX INC.
Entity Type:Organization
Organization Name:RISING PHOENIX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MEL
Authorized Official - Middle Name:DONTE
Authorized Official - Last Name:WESTMORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-558-5108
Mailing Address - Street 1:603 MONTROSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-1289
Mailing Address - Country:US
Mailing Address - Phone:336-855-3744
Mailing Address - Fax:336-855-3744
Practice Address - Street 1:603 MONTROSE DRIVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-1289
Practice Address - Country:US
Practice Address - Phone:336-855-3744
Practice Address - Fax:336-855-3744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-11
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness