Phoenix Healing Center LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

R 121129-6 Issued in MN

Legal business name

PHOENIX HEALING CENTER LLC

Practice address

1812 2ND St SW
Suite F
Rochester, MN 55902-4127

Phone

(507) 322-0222

Fax

(507) 322-0223

NPI assigned

Aug 31, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathleen Francette Flugel ColleNPI 1679871586

Title

PMH-CNS, Aprn-BC

Phone

(507) 421-2737

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Francette Flugel Colle, PMH-CNS, BC, APRN

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Rochester, MN
  • NPI 1679871586
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1972059806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 2ND ST SW",
            "address_2": "SUITE F",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024127",
            "telephone_number": "507-322-0222",
            "fax_number": "507-322-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 2ND ST SW",
            "address_2": "SUITE F",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559024127",
            "telephone_number": "507-322-0222",
            "fax_number": "507-322-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "FLUGEL COLLE",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "FRANCETTE",
        "authorized_official_title_or_position": "PMH-CNS, APRN-BC",
        "authorized_official_telephone_number": "507-421-2737"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MN",
            "license": "R 121129-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "890000607",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystyna Cios Phillips
• Ryan Matthew Phillips, M.D., PH.D.
• Trevor Phillips
• Valerie Luanne Phillips
• Philoxenia Charities
• Phoenix Psychology Services, PLLC
• Alice Piccinini, MD
• Ezequiel Agustin Piccione, M.D
• Laura Piccolo Serafim, M.D.
• Shannon Piche, PHARM.D., R.PH.

• Adult Mental Health Clinic/Center in Rochester, MN
• Providers in Rochester, MN by specialty
• Adult Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.