Phoenix House Of Support Corp

LBN: Phoenix House Of Support Corp
Phoenix House Of Support Corp is an health care organization with primary practice located at 8902 Sw 208Th Ter , Cutler Bay FL 33189-3884. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as the primary health care specialty. Phoenix House Of Support Corp can be contacted via phone (786) 301-1571, or through Viquillon, Tamara via phone (786) 301-1571.

Contact Information

Primary practice address
8902 Sw 208Th Ter Cutler Bay FL 33189-3884
Phone: (786) 301-1571
Fax: (305) 233-8594
Website:
Map and Directions
Authorized official contact:
Name: Viquillon, Tamara
Phone: (786) 301-1571

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 016029700 Florida

Profile Details

NPI number 1356897300
LBN Legal business name Phoenix House Of Support Corp
DBA Doing business as
Authorized official Viquillon, Tamara
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2016
Last updated Aug 30th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356897300 NPPES
Florida MEDICAID 016029700

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