Organization
PHOENIX RESOLUTIONS TREATMENT FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROECHARD EBANKS (CEO)
(914) 584-2395
Entity
Organization
Contact information
Practice address
518 SW PRIMA VISTA BLVD, SUITE B, PORT SAINT LUCIE, FL 34983-8734
(914) 584-2395
Mailing address
518 SW PRIMA VISTA BLVD, SUITE B, PORT SAINT LUCIE, FL 34983-8734
(914) 584-2395
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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