Phoenix Bridge Community Support

LBN: Phoenix Bridge Community Support
Phoenix Bridge Community Support is an health care organization with primary practice located at 814 Bradley St , Burlington NC 27215-6806. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Phoenix Bridge Community Support can be contacted via phone (336) 222-8522, or through Jones, Wendy Renee via phone (336) 222-8522.

Contact Information

Primary practice address
814 Bradley St Burlington NC 27215-6806
Phone: (336) 222-8522
Fax: (336) 222-8533
Website:
Map and Directions
Authorized official contact:
Name: Jones, Wendy Renee
Phone: (336) 222-8522

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL-001-121 North Carolina

Profile Details

NPI number 1508045998
LBN Legal business name Phoenix Bridge Community Support
DBA Doing business as
Authorized official Jones, Wendy Renee
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 1st, 2007
Last updated Nov 1st, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508045998 NPPES
North Carolina MEDICAID 6603578

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