| NPI | 1154778686 |
|---|---|
| Former Legal Business Name | PHOENIX RISING LLC |
| Entity Type | Organization |
| Authorized Contact | MICHELLE HARPER Owner/Director 505-414-7721 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2016-05-13 |