Phoenix Bridge Community Support

NPI #1508045998 in Burlington, North Carolina

Provider Information

NPI Number
1508045998
Entity Type
Organization
Organization Name
Phoenix Bridge Community Support
Subpart
Yes (part of a larger organization)
Parent Organization
PHOENIX BRIDGE GROUP HOME, INC.
Primary Specialty
Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date
Nov 1, 2007
Last Updated
Nov 1, 2007

Practice Location

Address
814 BRADLEY ST
ZIP Code
27215-6806
Phone
(336) 222-8522

Authorized Official

Name
MISS WENDY RENEE JONES
Title
PROGRAM DIRECTOR
Phone
(336) 222-8522

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Emotionally Disturbed Children

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