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Organization

PHOENIX CENTER FOR HEALING P.A.

Active
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Organization

PHOENIX CENTER FOR HEALING P.A.

Active
Parent organization
PHOENIX CENTER FOR HEALING P.A.
Organization subpart
Yes

Provider details

NPI number
Legal business name
PHOENIX CENTER FOR HEALING P.A.
Authorized official
MR. ROBERT HAFNER MENTAL HEALTH COUNSE (REGISTER AGENT FLORIDA CORP)
(786) 236-7927
Entity
Organization

Contact information

Practice address
11060 N KENDALL DR, SUITE 7, MIAMI, FL 33176-1272
(305) 345-3498
(305) 257-0040
Mailing address
14875 SW 238TH ST, HOMESTEAD, FL 33032-8702
(786) 236-7927
(305) 257-0040

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAP 2344
FL
101YM0800X
Mental Health Counselor
Primary
MH7474
FL
101YP1600X
Pastoral Counselor
—
—
103G00000X
Clinical Neuropsychologist
—
—
103TS0200X
School Psychologist
SS888
FL
106H00000X
Marriage & Family Therapist
—
—
174400000X
Specialist
—
—

Other

Enumeration date
08/21/2008
Last updated
08/21/2008
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