PHOENIX TREATMENT CENTER INC – NPI #1699440263
Family Medicine

A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.

Health Care Provider Taxonomy Code for Family Medicine

PHOENIX TREATMENT CENTER INC is a provider located in NITRO, WV. NPPES has assigned the NPI number 1699440263 to PHOENIX TREATMENT CENTER INC on August 15, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207QA0000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adolescent Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PHOENIX TREATMENT CENTER INC below.

NPI Profile for
PHOENIX TREATMENT CENTER INC

NPI Number
1699440263
Enumeration Date

(about 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PHOENIX TREATMENT CENTER INC
Primary location
4114 1ST AVE
NITRO, WV 25143-1304
Phone: (304) 755-0119 Fax:
Mailing address
PO BOX 11908
CHARLESTON, WV 25339-1908
Phone: Fax:
Organization Subpart
No
Authorized Official
MOHAMMAD KALOU
OWNER
Phone: (304) 688-7027
Updated
Certification Date
Aug 15, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0000X
- Family Medicine / Adolescent Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.