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THE PHOENIX GROUP LLC NPI 1518302801


NPI Information

NPI: 1518302801
Provider Name: THE PHOENIX GROUP, LLC

Doing Business As: THE PHOENIX GROUP

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
200 S 37TH ST APT F
COUNCIL BLUFFS, IA
ZIP 51501
Phone: (712) 355-8665
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THE PHOENIX GROUP, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Council Bluffs, IA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. THE PHOENIX GROUP, LLC NPI is 1518302801. The provider is registered as an organization entity type.
The provider Is Doing Business As The Phoenix Group.

The provider's business location address is:

200 S 37TH ST APT F
COUNCIL BLUFFS, IA
ZIP 51501-284
Phone: (712) 355-8665

The provider's authorized official is Keith Duane Mcmillen .
The authorized official title is Operations Director and has the following contact phone number (712) 355-8665.

The enumeration date for this NPI number is 5/1/2013 and was last updated on 7/9/2014.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities489DLC-456043IOWAYes

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: 4/28/2024

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