Organization
PHOENIX CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY E. HAM M.D. (PRESIDENT)
(808) 934-7355
Entity
Organization
Contact information
Practice address
169 PUUEO ST, HILO, HI 96720-2432
(808) 934-7355
(808) 935-3209
Mailing address
PO BOX 10840, HILO, HI 96721-5840
(808) 934-7355
(808) 935-3209
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
LCSW3200
HI
2084P0800X
Psychiatry Physician
Primary
MD8985
HI
Other
Enumeration date
11/20/2006
Last updated
12/12/2023
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