| NPI | 1780222976 |
|---|---|
| Former Legal Business Name | PHOENIX COUNSELING & TRAUMA TREATMENT CENTER, LLC |
| Entity Type | Organization |
| Authorized Contact | WILLIE MAE KENT Owner/Director 856-300-7770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |