Organization
PHOENIX CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY HAM (PRESIDENT)
(808) 934-7355
Entity
Organization
Contact information
Practice address
169 PUUEO ST, HILO, HI 96720-2432
(808) 934-7355
Mailing address
PO BOX 10840, HILO, HI 96721-5840
(808) 934-7355
(877) 803-8735
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MD-8985
HI
Other
Enumeration date
07/15/2005
Last updated
12/12/2023
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