| Phoenix Holistic Services Llc | |
|
15569 115th Rd Jamaica NY 11434-1023 | |
| (917) 226-6726 | |
| Not Available |
| Full Name | Phoenix Holistic Services Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 15569 115th Rd, Jamaica, New York |
| Authorized Official Name and Position | Allen E Smart (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 9172266726 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Holistic Services Llc 15569 115th Rd Jamaica NY 11434-1023 Ph: (917) 226-6726 | Phoenix Holistic Services Llc 15569 115th Rd Jamaica NY 11434-1023 Ph: (917) 226-6726 |
| NPI Number | 1215608146 |
|---|---|
| Provider Enumeration Date | 09/21/2021 |
| Last Update Date | 09/21/2021 |
| Certification Date | 09/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215608146 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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