NPI | 1316632672 |
---|---|
Doing Business As | PHOENIX CLINIC CHICAGO |
Entity Type | Organization |
Authorized Contact | TAYLOR ARIEL PETTWAY Executive Director 773-431-7397 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-04-11 |
Last Update Date | 2023-04-11 |