PHOENIX SUPPORTED LIVING INC – NPI #1174679948
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Mental Illness

PHOENIX SUPPORTED LIVING INC is a community based residential treatment facility located in ANDREWS, NC. NPPES has assigned the NPI number 1174679948 to PHOENIX SUPPORTED LIVING INC on January 26, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. 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 SUPPORTED LIVING INC below.

NPI Profile for
PHOENIX SUPPORTED LIVING INC

NPI Number
1174679948
Enumeration Date

(more than 19 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 SUPPORTED LIVING INC
Primary location
140 ADAMS DRIVE
ANDREWS, NC 28904
Phone: (828) 389-1795 Fax: (828) 389-1658
Mailing address
2996 NC 69 S.
SUITE 6
HAYESVILLE, NC 28904
Phone: (828) 389-1795 Fax: (828) 389-1658
Organization Subpart
No
Authorized Official
JANET NEMKOVICH
DIRECTOR
Phone: (828) 389-1795
Updated
Identifiers

Identifiers for PHOENIX SUPPORTED LIVING INC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDNC7805326
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
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)		 NC 7805326

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.