| NPI | 1639910003 |
|---|---|
| Former Legal Business Name | PHOENIX COUNSELING AND RECOVERY SERVICES |
| Entity Type | Organization |
| Authorized Contact | AMANDA A MAIKE CEO 239-286-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-06-01 |
| Last Update Date | 2024-12-09 |