| NPI | 1336654854 |
|---|---|
| Doing Business As | PHOENIX MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | LAURA TARR CEO 606-585-8985 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: OH 01-7588) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |