Provider Demographics
NPI:1528679032
Name:APEX RISING COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:APEX RISING COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-610-6375
Mailing Address - Street 1:4150 W PEORIA AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-3956
Mailing Address - Country:US
Mailing Address - Phone:602-825-1608
Mailing Address - Fax:602-391-2215
Practice Address - Street 1:4150 W PEORIA AVE STE 220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3956
Practice Address - Country:US
Practice Address - Phone:602-825-1608
Practice Address - Fax:602-391-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty