| NPI | 1346658234 |
|---|---|
| Doing Business As | GILMAN PHOENIX HOUSE |
| Entity Type | Organization |
| Authorized Contact | JOHN CHARLES HALBLEIB Managing Member 715-577-6524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |