Organization
PHOENIX FAMILY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE POTTER LCPC (C0-OWNER)
(224) 535-9555
Entity
Organization
Contact information
Practice address
474 SUMMIT ST, ELGIN, IL 60120
(847) 224-1256
Mailing address
474 SUMMIT ST, ELGIN, IL 60120-3829
(847) 224-1256
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
00
IL
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/23/2014
Last updated
07/21/2022
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