| Phoenix Therapeutic Foundation, Inc | |
|
5602 Baltimore National Pike Suite 700 Baltimore MD 21228-1411 | |
| (410) 744-9100 | |
| (410) 747-0226 |
| Full Name | Phoenix Therapeutic Foundation, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5602 Baltimore National Pike, Baltimore, Maryland |
| Authorized Official Name and Position | Amr A Elbeshir (PROGRAM DIRECTOR CEO) |
| Authorized Official Contact | 4107449100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Therapeutic Foundation, Inc 5602 Baltimore National Pike Suite 700 Baltimore MD 21228-1411 Ph: (410) 744-9100 | Phoenix Therapeutic Foundation, Inc 5602 Baltimore National Pike Suite 700 Baltimore MD 21228-1411 Ph: (410) 744-9100 |
| NPI Number | 1033247945 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 09/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033247945 | NPI | - | NPPES |
| 403344200 | Medicaid | MD |
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