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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