Phoenix Outdoor

NPI #1750522058 in Leicester, North Carolina

Provider Information

NPI Number: 1750522058
Entity Type: Organization
Organization Name: Phoenix Outdoor
Primary Specialty: Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children
Enumeration Date: Mar 16, 2009
Last Updated: Mar 16, 2009

Practice Location

Address: 631 WILLOW CREEK RD
City: Leicester
State: North Carolina
ZIP Code: 28748-5646
Phone: (828) 683-7718

Authorized Official

Name: MS. KAREN NILSEN
Title: OFFICE ASSISTANT
Phone: (828) 668-7590

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X	Primary

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