| Phoenix Health Professional Group, Llc | |
|
99 Wayland Ave Ste 100 Providence RI 02906-4314 | |
| (617) 771-1154 | |
| Not Available |
| Full Name | Phoenix Health Professional Group, Llc |
|---|---|
| Speciality | Psychologist - Addiction (substance Use Disorder) |
| Location | 99 Wayland Ave Ste 100, Providence, Rhode Island |
| Authorized Official Name and Position | Joel K Goloskie (COUNSEL) |
| Authorized Official Contact | 6177711154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Health Professional Group, Llc 1301 Atwood Ave Ste 100 Johnston RI 02919-4933 Ph: (617) 771-1154 | Phoenix Health Professional Group, Llc 99 Wayland Ave Ste 100 Providence RI 02906-4314 Ph: (617) 771-1154 |
| NPI Number | 1063037364 |
|---|---|
| Provider Enumeration Date | 06/11/2020 |
| Last Update Date | 06/11/2020 |
| Certification Date | 06/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063037364 | NPI | - | NPPES |
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