NPIMap

Organization Active NPI

Phoenix Home #1

  • Mental Illness Community Based Residential Treatment Facility
  • Raleigh, NC
National Provider Identifier
1194963371
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
092734
Legal business name
PHOENIX HOME #1
Practice address
2726 Newsome St
Raleigh, NC 27603-2956
Phone
(919) 771-4517
Fax
(919) 325-0671
NPI assigned
Jan 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Mr. Zulu Nwankwo
Title
Administrator
Phone
(919) 771-4517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 092734 Primary

Addresses

Primary practice location

2726 Newsome St
Raleigh, NC 27603-2956

Mailing address

2726 Newsome St
Raleigh, NC 27603-2956
Phone (919) 771-4517

National Provider Directory

National Provider Directory
Tax ID family
Champion Healthcare Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1233014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1194963371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 NEWSOME ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032956",
            "telephone_number": "919-771-4517",
            "fax_number": "919-325-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 NEWSOME ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032956",
            "telephone_number": "919-771-4517",
            "fax_number": "919-325-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOME #1",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-27",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "ZULU",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "919-771-4517",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": "092734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.