Phoenix Clinic INC of Broward

NPI #1811927262 in Miramar, Florida

Provider Information

NPI Number: 1811927262
Entity Type: Organization
Organization Name: Phoenix Clinic INC of Broward
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Jul 3, 2006
Last Updated: Aug 8, 2011

Practice Location

Address: 2212 SW 60TH TERRACE
City: Miramar
State: Florida
ZIP Code: 33023
Phone: (954) 491-2133

Authorized Official

Name: BONNIE GRAHAM
Title: CHIEF EXECUTIVE OFFICER
Phone: (305) 891-3439

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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