Phoenix Wellness Llc
LBN: Phoenix Wellness Llc
Phoenix Wellness Llc is an health care organization with primary practice located at 1040 Edgewater Corporate Pkwy Ste 106 , Fort Mill SC 29707-4526. The organization recently has 11 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Other Service Providers / Case Manager/Care Coordinator, Agencies / Case Management, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Prison Health, Ambulatory Health Care Facilities / VA. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Phoenix Wellness Llc can be contacted via phone (704) 609-7334, or through Smith, David N via phone (704) 609-7334.
Contact Information
Primary practice address
1040 Edgewater Corporate Pkwy Ste 106
Fort Mill SC 29707-4526
Phone: (704) 609-7334
Fax: (855) 655-3374
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | ||
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
Behavioral Health & Social Service Providers / Professional | 101YP2500X | ||
Other Service Providers / Case Manager/Care Coordinator | 171M00000X | ||
Agencies / Case Management | 251B00000X | ||
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) | 261QM0801X | ||
Ambulatory Health Care Facilities / Adult Mental Health | 261QM0850X | ||
Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | ||
Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
Ambulatory Health Care Facilities / Prison Health | 261QP2400X | ||
Ambulatory Health Care Facilities / VA | 261QV0200X |
Profile Details
NPI number | 1780348789 |
---|---|
LBN Legal business name | Phoenix Wellness Llc |
DBA Doing business as | |
Authorized official | Smith, David N Doctor of Medicine (MD) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Oct 26th, 2021 |
Last updated | Oct 26th, 2021 - about 3 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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