Phoenix Psychiatric Services
Clinic/Center, Adult Mental Health in Fall River, MA. Organization (NPI-2).
NPI number1033489109
StatusActive
Last updated in NPPESJan 6, 2012
Details
- NPI
- 1033489109
- Entity type
- Organization (NPI-2)
- Legal business name
- Phoenix Psychiatric Services
- Organization subpart
- No
- Enumeration date
- Jan 6, 2012
- Last updated
- Jan 6, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | 206747 | MA | Yes |
Practice location
101 Jeremiah Sullivan DrFall River, MA 02721
Phone 774-644-5629 · Fax 508-678-8100
Mailing address
3338 N Main StFall River, MA 02720-1609
Phone 508-676-5514
Authorized official
Ewa M. Conroy
Owner
5086765514
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