| Phoenix Therapeutic Foundation | |
|
5602 Baltimore National Pike Suburbia Bldg - Suite # 508/6 Baltimore MD 21228-1411 | |
| (410) 744-9100 | |
| (410) 747-0226 |
| Full Name | Phoenix Therapeutic Foundation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5602 Baltimore National Pike, Baltimore, Maryland |
| Authorized Official Name and Position | Amr A El-beshir (CEO/PROGRAM DIRECTOR) |
| Authorized Official Contact | 4107449100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Therapeutic Foundation 5602 Baltimore National Pike Suite 700 Baltimore MD 21228-1411 Ph: (410) 744-9100 | Phoenix Therapeutic Foundation 5602 Baltimore National Pike Suburbia Bldg - Suite # 508/6 Baltimore MD 21228-1411 Ph: (410) 744-9100 |
| NPI Number | 1336333079 |
|---|---|
| Provider Enumeration Date | 09/05/2007 |
| Last Update Date | 09/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336333079 | NPI | - | NPPES |
| 401254200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | D0016432 (Maryland) | Primary |
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