The Phoenix House LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

THE PHOENIX HOUSE LLC

Practice address

106 Chasteen Dr
Middlesboro, KY 40965-2519

Phone

(918) 896-8380

NPI assigned

Apr 20, 2026

Organization subpart

No

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

Authorized official

Name

Misty Dawn Panther

Title

Executive Director

Phone

(918) 896-8380

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1194660936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CHASTEEN DR",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652519",
            "telephone_number": "918-896-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 CHASTEEN DR",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652519",
            "telephone_number": "918-896-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHOENIX HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "PANTHER",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "918-896-8380"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; 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.