| Phoenix Health Associates Pllc | |
|
1021 Majestic Drive Suite 100 Lexington KY 40513-1492 | |
| (859) 737-0904 | |
| (859) 737-0902 |
| Full Name | Phoenix Health Associates Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1021 Majestic Drive, Lexington, Kentucky |
| Authorized Official Name and Position | Ramesh L Ghanta (OWNER) |
| Authorized Official Contact | 8597370904 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Health Associates Pllc P.o. Box 896 Winchester KY 40392-0896 Ph: (859) 737-0904 | Phoenix Health Associates Pllc 1021 Majestic Drive Suite 100 Lexington KY 40513-1492 Ph: (859) 737-0904 |
| NPI Number | 1841450665 |
|---|---|
| Provider Enumeration Date | 06/16/2008 |
| Last Update Date | 06/15/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841450665 | NPI | - | NPPES |
| 65941874 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | KY32188 (Kentucky) | Secondary |
| 251S00000X | Community/behavioral Health | KY35740 (Kentucky) | Primary |
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