| Full Name | Phoenix Center Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 169 Puueo St, Hilo, Hawaii |
| Authorized Official Name and Position | Shelley Ham (PRESIDENT) |
| Authorized Official Contact | 8089347355 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Center Inc Po Box 10840 Hilo HI 96721-5840 Ph: (808) 934-7355 | Phoenix Center Inc 169 Puueo St Hilo HI 96720-2432 Ph: (808) 934-7355 |
| NPI Number | 1710986351 |
|---|---|
| Provider Enumeration Date | 07/15/2005 |
| Last Update Date | 12/12/2023 |
| Certification Date | 12/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710986351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | MD-8985 (Hawaii) | Primary |
News Archive
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