| Red Phoenix Healing Llc | |
|
89 Main St Ste 304 Medway MA 02053-1815 | |
| (774) 573-1644 | |
| (774) 233-0037 |
| Full Name | Red Phoenix Healing Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 89 Main St Ste 304, Medway, Massachusetts |
| Authorized Official Name and Position | Cynthia Meeske (OWNER) |
| Authorized Official Contact | 7745731644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Red Phoenix Healing Llc 89 Main St Ste 304 Medway MA 02053-1815 Ph: (774) 573-1644 | Red Phoenix Healing Llc 89 Main St Ste 304 Medway MA 02053-1815 Ph: (774) 573-1644 |
| NPI Number | 1306305727 |
|---|---|
| Provider Enumeration Date | 03/15/2019 |
| Last Update Date | 05/14/2020 |
| Certification Date | 05/14/2020 |
| Medicare PECOS PAC ID | 9234556218 |
|---|---|
| Medicare Enrollment ID | O20200908000277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306305727 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Cynthia L Meeske |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508917378 PECOS PAC ID: 2961505482 Enrollment ID: I20070321000153 |
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