Provider Demographics
NPI:1225913890
Name:HOUSE OF THE RISING PHOENIX, LLC
Entity type:Organization
Organization Name:HOUSE OF THE RISING PHOENIX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-358-0978
Mailing Address - Street 1:8735 DUNWOODY PL # 10399
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2995
Mailing Address - Country:US
Mailing Address - Phone:504-358-0978
Mailing Address - Fax:504-226-5513
Practice Address - Street 1:2836 AMELIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-6804
Practice Address - Country:US
Practice Address - Phone:504-358-0978
Practice Address - Fax:504-226-5513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty