Phoenix House, Inc.

LBN: Phoenix House, Inc.
Phoenix House, Inc. is an health care organization with primary practice located at 8916 Woodhall Lake Dr , Waxhaw NC 28173-6800. 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 House, Inc. can be contacted via phone (704) 536-7931, or through Taylor, Leslie via phone (704) 536-7931.

Contact Information

Primary practice address
8916 Woodhall Lake Dr Waxhaw NC 28173-6800
Phone: (704) 536-7931
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Taylor, Leslie
Phone: (704) 536-7931

Health care specialties

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

Profile Details

NPI number 1124164405
LBN Legal business name Phoenix House, Inc.
DBA Doing business as
Authorized official Taylor, Leslie
Entity Organization
Organization subpart 1 No
Enumeration date Jan 30th, 2007
Last updated Aug 22nd, 2020 - about 4 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 1124164405 NPPES
North Carolina MEDICAID 6603730

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