| Phoenix N Peace Llc | |
|
3297 S Crater Rd Ste C Petersburg VA 23805-9384 | |
| (804) 862-8810 | |
| Not Available |
| Full Name | Phoenix N Peace Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3297 S Crater Rd Ste C, Petersburg, Virginia |
| Authorized Official Name and Position | Marilyn Coleman Newby (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8046779570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix N Peace Llc 3297 S Crater Rd Ste C Petersburg VA 23805-9384 Ph: (804) 862-8810 | Phoenix N Peace Llc 3297 S Crater Rd Ste C Petersburg VA 23805-9384 Ph: (804) 862-8810 |
| NPI Number | 1861171795 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 07/17/2023 |
| Certification Date | 07/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861171795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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