Organization
PHOENIX THERAPEUTIC FOUNDATION
Active
Parent organization
PHOENIX THERAPEUTIC FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX THERAPEUTIC FOUNDATION
Authorized official
MR. AMR A EL-BESHIR M.A. (CEO/PROGRAM DIRECTOR)
(410) 744-9100
Entity
Organization
Contact information
Practice address
5602 BALTIMORE NATIONAL PIKE, SUBURBIA BLDG - SUITE # 508/6, BALTIMORE, MD 21228-1411
(410) 744-9100
(410) 747-0226
Mailing address
5602 BALTIMORE NATIONAL PIKE, SUITE 700, BALTIMORE, MD 21228-1411
(410) 744-9100
(410) 747-0226
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
D0016432
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401254200
—
MD
Enumeration date
09/05/2007
Last updated
09/27/2012
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