Provider Demographics
NPI:1982992756
Name:PHOENIX RISING SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PHOENIX RISING SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGO
Authorized Official - Middle Name:V
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MA, PHR
Authorized Official - Phone:630-215-5226
Mailing Address - Street 1:333 N RANDALL RD STE 21
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1500
Mailing Address - Country:US
Mailing Address - Phone:630-215-5226
Mailing Address - Fax:630-318-3210
Practice Address - Street 1:333 N RANDALL RD STE 21
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1500
Practice Address - Country:US
Practice Address - Phone:630-215-5226
Practice Address - Fax:630-318-3210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-14
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty