PHOENIX RESOLUTIONS TREATMENT FACILITY NPI 1669858304

NPI Information

  • NPI: 1669858304
  • Provider Name: PHOENIX RESOLUTIONS TREATMENT FACILITY
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • Address: 518 SW PRIMA VISTA BLVD
    SUITE B
    PORT SAINT LUCIE, FL
    ZIP 34983
  • Phone: (914) 584-2395

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NPI Details

PHOENIX RESOLUTIONS TREATMENT FACILITY is a rehabilitation and substance use disorder clinic center in Port Saint Lucie, FL. PHOENIX RESOLUTIONS TREATMENT FACILITY NPI is 1669858304. The provider is registered as an organization entity type.

The provider's business location address is:

518 SW PRIMA VISTA BLVD
SUITE B
PORT SAINT LUCIE, FL
ZIP 34983-734
Phone: (914) 584-2395

The provider's authorized official is Roechard Ebanks .
The authorized official title is Ceo and has the following contact phone number (914) 584-2395.

The enumeration date for this NPI number is 8/5/2015 and was last updated on 8/5/2015.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

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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