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PHOENIX TREATMENT CENTER INC
NPI 1699440263
Family Medicine - Adolescent Medicine in Nitro, WV

Active since August 15, 2021

NPPES record last updated: August 15, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Phoenix Treatment Center Inc NPPES

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

PHOENIX TREATMENT CENTER INC (NPI 1699440263) is a healthcare organization registered as an adolescent medicine in Nitro, West Virginia and active in the NPI registry since August 2021. The organization lists Mohammad Kalou, Owner, as its authorized official.

NPPES Registry Identity

NPI1699440263
Entity TypeOrganization
Primary Taxonomy207QA0000X
Legal Business NamePHOENIX TREATMENT CENTER INC
Location Address4114 1ST AVENitro, WV 25143-1304
Mailing AddressPo Box 11908Charleston, WV 25339-1908
Phone(304) 755-0119
Organization SubpartNo
Authorized OfficialMohammad KalouOwner · (304) 688-7027
Enumeration DateAugust 15, 2021
NPPES CertifiedAugust 15, 2021
✔ NPI 1699440263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0000X
Definition
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
4114 1ST AVE, Nitro, WV 25143
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

KARLIE PERKINS
Nurse Practitioner (Family)
4114 1ST AVE
NITRO, WV 25143
Kanawha County (304) 755-0119
BETSY DAWN LEGG FNP-MSN
Registered Nurse (School)
4114 1ST AVE
NITRO, WV 25143
Kanawha County (304) 755-0119
MOUNTAINEER FAMILY MEDICINE, INC.
Family Medicine
4114 1ST AVE
NITRO, WV 25143
Kanawha County (304) 755-0119
MODERN MEDICINE INC
Family Medicine
4114 1ST AVE
NITRO, WV 25143
Kanawha County (304) 755-0119

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 Treatment Center Inc's NPI number?

The NPI number for Phoenix Treatment Center Inc is 1699440263. It was assigned to this organization in the NPPES registry on August 15, 2021.

Where is Phoenix Treatment Center Inc located?

Phoenix Treatment Center Inc is located at 4114 1st Ave, Nitro, WV 25143. The listed phone number is (304) 755-0119.

What is Phoenix Treatment Center Inc's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adolescent Medicine, with taxonomy code 207QA0000X.

When was this NPI record last updated?

The NPPES record for Phoenix Treatment Center Inc was last updated on August 15, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.