| NPI | 1518563329 |
|---|---|
| Doing Business As | PHOENIX COMMUNITY SUPPORT SERVICES LLC |
| Entity Type | Organization |
| Authorized Contact | LASHUNDA SMITH POPE Owner 803-849-2925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2020-12-07 |