Organization
PHOENIX HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE LIVELY MBA (CHIEF OPERATING OFFICER)
(443) 878-1111
Entity
Organization
Contact information
Practice address
5616 PARK HEIGHTS AVE, 1ST AND 2ND FLOOR, BALTIMORE, MD 21215-3969
(443) 878-1111
Mailing address
5616 PARK HEIGHTS AVE, BALTIMORE, MD 21215-3969
(443) 878-1111
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/08/2022
Last updated
02/24/2025
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