Organization
PHOENIX CENTER BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHONTAON MICHELLE DEAN (LPN)
(478) 988-1222
Entity
Organization
Contact information
Practice address
940 HIGHWAY 96 STE A, WARNER ROBINS, GA 31088-2587
(478) 988-1222
(478) 988-1422
Mailing address
940 HIGHWAY 96 STE A, WARNER ROBINS, GA 31088-2587
(478) 988-1222
(478) 988-1422
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
58215225
—
GA
Enumeration date
11/14/2008
Last updated
07/21/2022
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