Organization
PHOENIX BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHIL FUHRER (CFO)
(609) 771-3777
Entity
Organization
Contact information
Practice address
1014 WHITEHEAD ROAD EXT, EWING, NJ 08638-2406
(609) 771-3777
Mailing address
1014 WHITEHEAD ROAD EXT, EWING, NJ 08638-2406
(609) 771-3777
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0468665
—
NJ
Enumeration date
10/02/2017
Last updated
10/02/2017
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