| Healed Phoenix Behavioral Health Llc | |
|
1033 Sw Yamhill St Ste 101 Portland OR 97205-2537 | |
| (513) 252-6939 | |
| Not Available |
| Full Name | Healed Phoenix Behavioral Health Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1033 Sw Yamhill St Ste 101, Portland, Oregon |
| Authorized Official Name and Position | Tiffany Bryant (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 5132526939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healed Phoenix Behavioral Health Llc 12317 W Denton Ave Litchfield Park AZ 85340-3434 Ph: (513) 252-6939 | Healed Phoenix Behavioral Health Llc 1033 Sw Yamhill St Ste 101 Portland OR 97205-2537 Ph: (513) 252-6939 |
| NPI Number | 1346066495 |
|---|---|
| Provider Enumeration Date | 11/22/2024 |
| Last Update Date | 12/05/2024 |
| Certification Date | 12/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346066495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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