Provider Demographics
NPI:1255579595
Name:RISING PHOENIX HEALING ARTS, LLC
Entity type:Organization
Organization Name:RISING PHOENIX HEALING ARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORSS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, OMD
Authorized Official - Phone:303-487-6283
Mailing Address - Street 1:PO BOX 33776
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80233-0776
Mailing Address - Country:US
Mailing Address - Phone:303-487-6283
Mailing Address - Fax:303-487-6923
Practice Address - Street 1:8859 FOX DR
Practice Address - Street 2:SUITE 205
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-6899
Practice Address - Country:US
Practice Address - Phone:303-487-6283
Practice Address - Fax:303-487-6923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-24
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1294171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty