NPIMap

Organization Active NPI

Phoenix House Child Agency

  • Custodial Care Facility
  • Waxhaw, NC
National Provider Identifier
1053586065
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
Legal business name
PHOENIX HOUSE CHILD AGENCY
Practice address
8916 Woodhall Lake Dr
Waxhaw, NC 28173-6800
Phone
(704) 536-7931
NPI assigned
Apr 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Leslie Taylor
Title
Social Worker
Phone
(704) 536-7931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X Primary

Addresses

Primary practice location

8916 Woodhall Lake Dr
Waxhaw, NC 28173-6800

Mailing address

8916 Woodhall Lake Dr
Waxhaw, NC 28173-6800
Phone (704) 536-7931

National Provider Directory

National Provider Directory
Tax ID family
Phoenix House Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1053586065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8916 WOODHALL LAKE DR",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736800",
            "telephone_number": "704-536-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8916 WOODHALL LAKE DR",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736800",
            "telephone_number": "704-536-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSE CHILD AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "704-536-7931",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waxhaw, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.