Provider Demographics
NPI:1982447157
Name:THE RISING PHOENIX SOCIETY CO
Entity type:Organization
Organization Name:THE RISING PHOENIX SOCIETY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-687-6008
Mailing Address - Street 1:7601 FM 1960 RD E # 303
Mailing Address - Street 2:
Mailing Address - City:ATASCOCITA
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2209
Mailing Address - Country:US
Mailing Address - Phone:678-687-6008
Mailing Address - Fax:281-456-4850
Practice Address - Street 1:16755 W LAKE HOUSTON PKWY APT 801
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-6369
Practice Address - Country:US
Practice Address - Phone:678-687-6008
Practice Address - Fax:281-456-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-17
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Yes251E00000XAgenciesHome Health
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No385H00000XRespite Care FacilityRespite Care