Organization
PHOENIX RESIDENTIAL SERVICES
Active
Organization
PHOENIX RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRA B LEONARD (PRESIDENT)
(248) 338-3743
Entity
Organization
Contact information
Practice address
108 FRANKLIN BLVD, PONTIAC, MI 48341-1706
(248) 338-3743
Mailing address
108 FRANKLIN BLVD, PONTIAC, MI 48341-1706
(248) 338-3743
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AS630244869
MI
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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