Phoenix Adolescent Outpatient Treatment
Organization Active NPI Community/Behavioral Health Agency · Minneapolis, MN
NPI 1003096447 · NPPES record last updated Nov 13, 2007
Key facts
- NPI
- 1003096447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 1034578-1-CDT (MN)
- Legal business name
- PHOENIX ADOLESCENT OUTPATIENT TREATMENT
- Practice address
- 601 13TH Ave SE
Minneapolis, MN 55414-1437 - Phone
- (651) 734-3268
- Fax
- (612) 378-4886
- NPI assigned
- Nov 13, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- PHOENIX GROUP HOMES, INC.
Authorized official
- Name
- Howard Louis Meier Jr., LADC
- Title
- Director
- Phone
- (651) 230-1895
Corporate family (same tax ID) 6
National Provider Directory
- Tax ID family
- Phoenix Recovery Programs Inc
- Part of
- Phoenix Recovery Programs Inc
Locations
601 13th Ave SE
Minneapolis, MN 55414
Phone (651) 734-3268
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 1034578-1-CDT | MN | Yes |
Addresses
Primary practice location
601 13TH Ave SE
Minneapolis, MN 55414-1437
Mailing address
1011 Interlachen Pkwy
Woodbury, MN 55125-8852
Phone (651) 230-0849
Other providers in Minneapolis, MN
- Brittany Alexis Philpot
- Nicholas John Philpot
- Ashley Phimister
- Brenda Jo Phipps
- Sharmyn Phipps
- Phoenix Center, LLC
- Phoenix Home Health Care
- Phoenix Mental Health, P.L.C.
- Phoenix Nest Inc.
- Phoenix Pulse LLC
All providers in Minneapolis, MN · Community/Behavioral Health Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.