PHOENIX GROUP HOME LLC NPI 1336654854

NPI Information

  • NPI: 1336654854
  • Provider Name: PHOENIX GROUP HOME, LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • :
  • CLIA Number: 36D2323407
  • Address: 3012 GLENMORE AVE STE 104
    CINCINNATI, OH
    ZIP 45238
  • Phone: (740) 858-1659

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NPI Details

PHOENIX GROUP HOME, LLC is a substance abuse rehabilitation facility in Cincinnati, OH. The provider is 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. PHOENIX GROUP HOME, LLC NPI is 1336654854. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

3012 GLENMORE AVE STE 104
CINCINNATI, OH
ZIP 45238-258
Phone: (740) 858-1659
Fax: (740) 876-9213

The provider's authorized official is Abbie Carpenter .
The authorized official title is Credentialing Specialist and has the following contact phone number (304) 794-6285.

The CLIA number assigned to this NPI record is 36D2323407 - other - mental health with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/6/2017 and was last updated on 2/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes
23245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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