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PHOENIX GROUP HOME, LLC
NPI 1336654854
Substance Abuse Rehabilitation Facility in Cincinnati, OH

Active since December 06, 2017CLIA 36D2330942 · Waiver
3012 GLENMORE AVE STE 104, CINCINNATI, OH 45238(740) 858-1659(740) 876-9213 Get Directions Write a Review

NPPES record last updated: February 6, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 6, 2026, Feb 24, 2025, Nov 8, 2024 and 1 more (4 updates tracked since 2017).

About Phoenix Group Home, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHOENIX GROUP HOME, LLC (NPI 1336654854), doing business as Path Behavioral Health- Sud, is a healthcare organization registered as a substance abuse rehabilitation facility in Cincinnati, Ohio and active in the NPI registry since December 2017. The organization holds a CLIA Waiver certificate valid through September 23, 2027, maintains 20 additional practice locations, and lists Abbie Carpenter, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1336654854
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NamePHOENIX GROUP HOME, LLC
Location Address3012 GLENMORE AVE STE 104Cincinnati, OH 45238-2258
Mailing Address3012 Glenmore Ave Ste 104Cincinnati, OH 45238-2258 · (740) 858-1659 · Fax (740) 876-9213
Phone(740) 858-1659
Fax(740) 876-9213
Organization SubpartYesParent: Phoenix Group Home Llc
Authorized OfficialAbbie CarpenterCredentialing Specialist · (304) 794-6285
Enumeration DateDecember 6, 2017
Last NPPES UpdateFebruary 6, 20264 updates tracked since enumeration
NPPES CertifiedFebruary 6, 2026
✔ NPI 1336654854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
Also ListedSubstance Abuse Rehabilitation Facility · Substance Abuse Treatment, ChildrenTaxonomy 3245S0500X
3012 GLENMORE AVE STE 104, Cincinnati, OH 45238
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Other Names 3

Doing Business AsPath Behavioral Health- Sud
Doing Business AsPath Behavioral Healthcare
Doing Business AsPath Integrated Health

Secondary Practice Locations 20

Location 1905 N Main StFindlay, OH 45840-3670 · Phone (567) 525-4100
Location 210 Myrtle AveGallipolis, OH 45631-9772 · Phone (740) 208-7462
Location 3701 Hildreth LnMarietta, OH 45750-1768 · Phone (740) 371-7194
Location 4188 W Hebble AveFairborn, OH 45324-4960 · Phone (937) 754-5911
Location 5757 Columbus AveLebanon, OH 45036-1607 · Phone (513) 836-8230
Location 611201 Shaker Blvd Ste 102Cleveland, OH 44104-3833 · Phone (216) 758-4120
Location 7111 W Water StChillicothe, OH 45601-2452 · Phone (740) 851-6493
Location 81605 11th StPortsmouth, OH 45662-4525 · Phone (740) 340-1427
Location 97211 N Main StDayton, OH 45415-2566 · Phone (937) 791-1427
Location 1049 Johnson RdTHE PLAINS, OH 45780-1146 · Phone (740) 764-4529
Location 119711 E Pike Rd Rm 104Cambridge, OH 43725-8936 · Phone (740) 825-8543
Location 12126 N Cross StWest Union, OH 45693-1209 · Phone (740) 340-1460
Location 1353 W Main StXenia, OH 45385-2979 · Phone (937) 971-2350
Location 14221 W Emmitt Ave # 1Waverly, OH 45690-1005 · Phone (740) 835-4054
Location 15399 Lincoln Park Dr Ste ANew Lexington, OH 43764-1078 · Phone (740) 960-0380
Location 163044 Columbus Lancaster Rd NWLancaster, OH 43130-8125 · Phone (740) 883-9300
Location 17151 S Kennebec AveMcConnelsville, OH 43756-1211 · Phone (740) 960-0380
Location 181235 W Market StLima, OH 45805-2728 · Phone (567) 289-6060
Location 191404 N High StHillsboro, OH 45133-8692 · Phone (740) 400-0411
Location 2031500 Chieftain Dr Unit BcLogan, OH 43138-8421 · Phone (740) 270-3286

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2330942

Phoenix Group Home LLC Dba Path Behavioral Healthcare · Waverly, OH
Active · expires Sep 23, 2027
CLIA Number36D2330942
Laboratory TypeMental Health Program
Certificate Effective DateSeptember 24, 2025
Certificate Expiration DateSeptember 23, 2027
Laboratory DirectorAbdelrahman Abdelaziz
Laboratory Phone(740) 835-4054
Laboratory LocationPhoenix Group Home LLC Dba Path Behavioral Healthcare221 W Emmitt Ave #1, Waverly, OH 45690
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS JULIE SMITH CT
Case Manager/Care Coordinator
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (283) 218-1263
SARAH M. RATHJE
Case Manager/Care Coordinator
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (513) 914-1815
DANIEL J.R. DELP
Case Manager/Care Coordinator
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (808) 679-5510
MR. KYLE MATTHEW BLEVINGS LAT, ATC
Case Manager/Care Coordinator
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (844) 584-7284
MS. ANJANETTE GARDNER MSN, APRN, PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (513) 913-1815
ELENA GRAF
Counselor (Professional)
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (513) 914-1815
MR. ROLAND ALEXANDER KOCSIS PCC-S
Counselor (Professional)
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (513) 914-1815
MISS PALAS SPEARMAN CDCA, MFT-T
Marriage & Family Therapist
3012 GLENMORE AVE STE 104
CINCINNATI, OH 45238
Hamilton County (513) 443-1679

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phoenix Group Home, LLC's NPI number?

The NPI number for Phoenix Group Home, LLC is 1336654854. It was assigned to this organization in the NPPES registry on December 6, 2017. The provider is doing business as Path Behavioral Health- SUD, Path Behavioral Healthcare and Path Integrated Health.

Where is Phoenix Group Home, LLC located?

Phoenix Group Home, LLC is located at 3012 Glenmore Ave Ste 104, Cincinnati, OH 45238. The listed phone number is (740) 858-1659.

What is Phoenix Group Home, LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Phoenix Group Home, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2330942) is associated with this NPI, valid through September 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Phoenix Group Home, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Molina Healthcare list Phoenix Group Home, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Phoenix Group Home, LLC was last updated on February 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.