Provider Demographics
NPI:1336852474
Name:RISING SUN MENTAL HEALTH PLLC
Entity Type:Organization
Organization Name:RISING SUN MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIFLET
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:806-577-2321
Mailing Address - Street 1:27331 PENDLETON TRACE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4266
Mailing Address - Country:US
Mailing Address - Phone:806-577-2321
Mailing Address - Fax:
Practice Address - Street 1:1160 DAIRY ASHFORD RD STE 605
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-3022
Practice Address - Country:US
Practice Address - Phone:806-577-2321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELLIE MENTAL HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty