Organization
PHOEGENESIS, INC
Active
Other names
PhoeGenesis, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES ELLIS LCSW-C (PRESIDENT)
(909) 576-2224
Entity
Organization
Contact information
Practice address
1901 S CHARLES ST, BALTIMORE, MD 21230-4867
(909) 576-2224
Mailing address
1901 S CHARLES ST, BALTIMORE, MD 21230-4867
(909) 576-2224
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/04/2021
Last updated
07/04/2021
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