Organization
PHOENIX THERAPY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA A. BUCHHOLZ (CEO)
(701) 206-0955
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
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/14/2023
Last updated
09/25/2023
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