| Red Phoenix Recovery Llc | |
|
1554 Wood St Fortuna CA 95540-3541 | |
| (707) 498-1865 | |
| Not Available |
| Full Name | Red Phoenix Recovery Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1554 Wood St, Fortuna, California |
| Authorized Official Name and Position | Marilynne Sue Walpole (OWNER/CEO) |
| Authorized Official Contact | 7074981865 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Phoenix Recovery Llc 1554 Wood St Fortuna CA 95540-3541 Ph: (707) 498-1865 | Red Phoenix Recovery Llc 1554 Wood St Fortuna CA 95540-3541 Ph: (707) 498-1865 |
| NPI Number | 1962252908 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/23/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962252908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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