Phoenix Clinic, Inc. | |
13730 Nw 6th Ct North Miami FL 33168-2931 | |
(305) 891-3439 | |
Not Available |
Full Name | Phoenix Clinic, Inc. |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 13730 Nw 6th Ct, North Miami, Florida |
Authorized Official Name and Position | Bonnie Graham (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3058913439 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Phoenix Clinic, Inc. 13730 Nw 6th Ct North Miami FL 33168-2931 Ph: (305) 891-3439 | Phoenix Clinic, Inc. 13730 Nw 6th Ct North Miami FL 33168-2931 Ph: (305) 891-3439 |
NPI Number | 1043304140 |
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Provider Enumeration Date | 10/03/2006 |
Last Update Date | 08/27/2008 |
Identifier | Type | State | Issuer |
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1043304140 | NPI | - | NPPES |
1113AD081801 | Other | FL | SUBSTANCE ABUSE LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 1113AD081801 (Florida) | Primary |
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