Organization
PHOENIX HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE LIVELY MBA (COO)
(443) 631-3303
Entity
Organization
Contact information
Practice address
4000 SPRUCE DR, BALTIMORE, MD 21215-7048
(443) 631-3303
Mailing address
5616 PARK HEIGHTS AVE, BALTIMORE, MD 21215-3969
(443) 631-3303
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
02/05/2025
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