Organization
PHOENIX HEALING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN FRANCETTE FLUGEL COLLE (PMH-CNS, APRN-BC)
(507) 421-2737
Entity
Organization
Contact information
Practice address
1812 2ND ST SW, SUITE F, ROCHESTER, MN 55902-4127
(507) 322-0222
(507) 322-0223
Mailing address
1812 2ND ST SW, SUITE F, ROCHESTER, MN 55902-4127
(507) 322-0222
(507) 322-0223
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
R 121129-6
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
890000607
MEDICARE PTAN
MN
Enumeration date
08/31/2016
Last updated
08/31/2016
Update your record
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