Phoenix Supported Living Inc in Hayesville - Residential Treatment Facility, Intellectual And/or Developmental Disabilities

Phoenix Supported Living Inc - NPI 1366598336

Phoenix Supported Living Inc is a Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Hayesville, North Carolina. Phoenix Supported Living Inc practices all healthcare services and medical treatments related to Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Phoenix Supported Living Inc is 1366598336. The last update date is 2012-05-11.

Phoenix Supported Living Inc's current location address is 2996 Nc 69, Hayesville, North Carolina. You can contact this provider via phone number 8283891795 and fax number 8283891658. The mailing address for Phoenix Supported Living Inc is 2996 Nc 69, Hayesville, North Carolina. To know further, please read the information below!

Provider Profile Detail

Provider Organization Phoenix Supported Living Inc
Address 2996 Nc 69, Hayesville, North Carolina
Phone Number 8283891795
Fax Number 8283891658
Sole Proprietor --
Credentials --

Authorized Official

Title or Position DIRECTOR
Authorized Official Name Nemkovich Melissa Janet
Telephone Number 8283891795

NPI Number Detail

NPI Number 1366598336
Provider Enumeration Date 2007-01-25
Last Updated Date 2012-05-11

Provider Mailing Address Detail

Address 2996 Nc 69
City Hayesville
State North Carolina (NC)
Post Code 289047257
Phone Number 8283891795
Fax Number 8283891658

Provider's Primary Taxonomy Detail

Speciality Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Taxonomy 320600000X
Licence No 7804847
Definition:
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
7804847 NC --

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FAQs about Phoenix Supported Living Inc

What is the Phoenix Supported Living Inc's unique identification number?

The Phoenix Supported Living Inc has been assigned the NPI (National Provider Identifier) Number 1366598336 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.

Could you please provide the complete street address where Phoenix Supported Living Inc is physically located?

The Phoenix Supported Living Inc is physically situated at the following address: 2996 Nc 69, Hayesville, NC, 289047257.

What is Phoenix Supported Living Inc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?

The specialized area of practice for Phoenix Supported Living Inc is Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the taxonomy code that categorizes this field of expertise is 320600000X.

When was the Phoenix Supported Living Inc's 1366598336 issued?

The Phoenix Supported Living Inc's 1366598336 was issued on 2007-01-25.

As of what date were the Phoenix Supported Living Inc's details last updated?

The information pertaining to the Phoenix Supported Living Inc, including its address, specialty, and other details, was most recently updated on 2012-05-11.

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