| Phoenix Treatment Center Llc | |
|
11 Garden St Ste 306 Mount Holly NJ 08060-1947 | |
| (609) 880-5047 | |
| Not Available |
| Full Name | Phoenix Treatment Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 11 Garden St Ste 306, Mount Holly, New Jersey |
| Authorized Official Name and Position | Anna M Galindez (CEO) |
| Authorized Official Contact | 6092223945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Treatment Center Llc 11 Garden St Ste 306 Mount Holly NJ 08060-1947 Ph: (609) 880-5047 | Phoenix Treatment Center Llc 11 Garden St Ste 306 Mount Holly NJ 08060-1947 Ph: (609) 880-5047 |
| NPI Number | 1497478259 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/26/2022 |
| Medicare PECOS PAC ID | 3971045733 |
|---|---|
| Medicare Enrollment ID | O20240607001310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497478259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Debra S Bradin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487409694 PECOS PAC ID: 0143762310 Enrollment ID: I20240604002039 |
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