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General NPI Number Information
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NPI Number | 1245921824
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Entity Type | Organization
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Legal Business Name | THE PHOENIX INSTITUTE OF HEALTH LLC
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 600 ROSE ST
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City | MONROE
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State | LA
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Zip | 71202-4641
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Country | US
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Telephone | 318-450-1418
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5033
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City | MONROE
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State | LA
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Zip | 71211-5033
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LEVI PAYNE
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Credential |
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Telephone | 318-450-1418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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