PHOENIX OUTDOOR - NPI 1750522058 - Substance Abuse Rehabilitation Facility in Leicester, NC

Q: What is Phoenix Outdoor's NPI number?

The NPI number for Phoenix Outdoor is 1750522058. It was assigned to this organization in the NPPES registry on March 16, 2009.

Q: What is Phoenix Outdoor's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility, specializing in Substance Abuse Treatment, Children, with taxonomy code 3245S0500X.

Q: When was this NPI record last updated?

The NPPES record for Phoenix Outdoor was last updated on March 16, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Phoenix Outdoor NPPES

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

PHOENIX OUTDOOR (NPI 1750522058) is a healthcare organization registered as a substance abuse treatment, children in Leicester, North Carolina and active in the NPI registry since March 2009. The organization lists Karen Nilsen, Office Assistant, as its authorized official.

NPPES Registry Identity

NPI1750522058

Entity TypeOrganization

Primary Taxonomy3245S0500X

Legal Business NamePHOENIX OUTDOOR

Location Address631 WILLOW CREEK RDLeicester, NC 28748-5646

Mailing Address631 Willow Creek RdLeicester, NC 28748-5646 · (828) 683-7718 · Fax (828) 683-9995

Phone(828) 683-7718

Fax(828) 683-9995

Organization SubpartNo

Authorized OfficialKaren NilsenOffice Assistant · (828) 668-7590

Enumeration DateMarch 16, 2009

✔ NPI 1750522058 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySubstance Abuse Rehabilitation Facility · Substance Abuse Treatment, ChildrenResidential Treatment Facilities

Taxonomy Code3245S0500X

License✔ Licensed in NC · MHL-011-279

Definition

A facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

Also ListedResidential Treatment Facility, Emotionally Disturbed ChildrenTaxonomy 322D00000X · License MHL-011-279 (NC)

631 WILLOW CREEK RD, Leicester, NC 28748

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Other Providers at the Same Location NPPES 16

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

CARRIE SCHEAR

Social Worker (Clinical)