PHOENIX HEALTH CENTER LLC NPI 1992009864

NPI Information

NPI: 1992009864
Provider Name: PHOENIX HEALTH CENTER, LLC
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

Address:
101 KING ST
HAGERSTOWN, MD
ZIP 21740
Phone: (301) 447-2361
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PHOENIX HEALTH CENTER, LLC is a methadone clinic center in Hagerstown, MD. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. PHOENIX HEALTH CENTER, LLC NPI is 1992009864. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

101 KING ST
HAGERSTOWN, MD
ZIP 21740-732
Phone: (301) 447-2361
Fax: (301) 447-3673

The provider's authorized official is William J Roby .
The authorized official title is Executive Vice President and has the following contact phone number (301) 447-2360.

The enumeration date for this NPI number is 1/6/2011 and was last updated on 1/6/2011.

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 State	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	MARYLAND	No
2	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry	MARYLAND	No
3	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	MARYLAND	No
4	261QM0850X	Clinic/Center	Adult Mental Health	MARYLAND	No
5	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	MARYLAND	No
6	101YA0400X	Counselor	Addiction (Substance Use Disorder)	MARYLAND	No
7	101YM0800X	Counselor	Mental Health	MARYLAND	No
8	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	MARYLAND	No
9	1041C0700X	Social Worker	Clinical	MARYLAND	No
10	207QA0401X	Family Medicine	Addiction Medicine	MARYLAND	No
11	207RA0401X	Internal Medicine	Addiction Medicine	MARYLAND	No
12	2084A0401X	Psychiatry & Neurology	Addiction Medicine	MARYLAND	No
13	261QM2800X	Clinic/Center	Methadone	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PENDING	MEDICAID	MARYLAND

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

NPI Synchronization or Removal

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