Phoenix Residential Centers, Inc.
NPI #1629467972 in Painesville, Ohio
Provider Information
- NPI Number
- 1629467972
- Entity Type
- Organization
- Organization Name
- Phoenix Residential Centers, Inc.
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Jan 9, 2015
- Last Updated
- Jan 9, 2015
Practice Location
- Address
- 12345 MEREDITH LN
- City
- Painesville
- State
- Ohio
- ZIP Code
- 44077-9246
- Phone
- (440) 428-9082
Authorized Official
- Name
- MS. MARY JO JASKELA
- Title
- CONTROLLER
- Phone
- (440) 428-9082
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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