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Organization

PHOENIX COMMUNITY SUPPORT SERVICES LLC

Active
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Organization

PHOENIX COMMUNITY SUPPORT SERVICES LLC

Active
Other names
Phoenix Community Support Services LLC
Organization subpart
No

Provider details

NPI number
Authorized official
LASHUNDA SMITH POPE (OWNER)
(803) 849-2925
Entity
Organization

Contact information

Practice address
4111 AVENUE L, BIRMINGHAM, AL 35208-1807
(803) 849-2925
Mailing address
4111 AVENUE L, BIRMINGHAM, AL 35208-1807
(803) 849-2925

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—

Other

Enumeration date
12/07/2020
Last updated
12/07/2020
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