Organization
PHOENIX THERAPY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA A. BUCHHOLZ LMSW (OWNER)
(701) 523-3285
Entity
Organization
Contact information
Practice address
402 6TH AVE SW, BOWMAN, ND 58623-4506
(701) 206-0955
Mailing address
602 1ST ST NW, BOWMAN, ND 58623-4461
(701) 206-0955
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467842294
—
ND
Enumeration date
11/30/2022
Last updated
11/30/2022
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