# PHOENIX THERAPEUTIC FOUNDATION, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184983637
- **Authorized official:** AMR A ELBESHIR M.A. (CEO)
- **Authorized official phone:** (410) 744-9100

## Contact information

- **Practice address:** 5602 BALTIMORE NATIONAL PIKE, SUITE 700, BALTIMORE, MD 21228-1411
- **Practice address phone:** (410) 744-9100
- **Practice address fax:** (410) 747-0226
- **Mailing address:** 5602 BALTIMORE NATIONAL PIKE, SUITE 700, BALTIMORE, MD 21228-1411
- **Mailing address phone:** (410) 744-9100
- **Mailing address fax:** (410) 747-0226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2012
- **Last updated:** 05/03/2012