| 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 |