PHOENIX RESIDENTIAL CENTERS INC. NPI 1629467972

NPI Information

PHOENIX RESIDENTIAL CENTERS, INC. is an intermediate care facility mentally retarded in Painesville, OH. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. PHOENIX RESIDENTIAL CENTERS, INC. NPI is 1629467972. The provider is registered as an organization entity type.
The provider Is Doing Business As Meredith Lane Family Home.

The provider's business location address is:

12345 MEREDITH LN
PAINESVILLE, OH
ZIP 44077-246
Phone: (440) 428-9082

The provider's authorized official is Mary Jo Jaskela .
The authorized official title is Controller and has the following contact phone number (440) 428-9082.

The enumeration date for this NPI number is 1/9/2015 and was last updated on 1/9/2015.

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:

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