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Organization
GREEN PHOENIX BEHAVIORAL HEALTH SERVICES
Active
Organization
GREEN PHOENIX BEHAVIORAL HEALTH SERVICES
Active
Other names
Green Phoenix
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LEAH RODRIGUEZ ROGERS LPC (OWNER)
(570) 855-9404
Entity
Organization
Contact information
Practice address
3154 MEMORIAL HWY STE 100, DALLAS, PA 18612-9203
(570) 855-9404
Mailing address
2182 STATE ROUTE 29 HWY, HUNLOCK CREEK, PA 18621-4512
(570) 239-8052
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/05/2024
Last updated
08/26/2024
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