| NPI | 1467763276 |
|---|---|
| Doing Business As | PHOENIX RECOVERY SERVICES, LLC, ISLAND |
| Entity Type | Organization |
| Authorized Contact | CAROL RUTH HUNDAHL Owner/Administrator 360-848-8437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: WA 15145300) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |