The Phoenix Recovery Support Services and Sober Living Environments LL

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

THE PHOENIX RECOVERY SUPPORT SERVICES AND SOBER LIVING ENVIRONMENTS LL

Practice address

3311 12TH St NW
Canton, OH 44708-3909

Phone

(234) 214-9731

NPI assigned

Jun 23, 2022

Last updated

Oct 9, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Korey A McCreeryNPI 1619512787

Title

President / Operations

Phone

(234) 214-9731

Specialties & licenses 3

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Korey A McCreery, COPRS-S

  • Peer Specialist
  • Canton, OH
  • NPI 1619512787
  NPD Authorized official
• Dean Elmer Roach

  • Peer Specialist
  • Canton, OH
  • NPI 1609592609
  NPD
• John Eric Holton

  • Peer Specialist
  • Canton, OH
  • NPI 1194682252
  NPD (past)

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791504000000",
    "number": "1225769847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 12TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083909",
            "telephone_number": "234-214-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 12TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447083909",
            "telephone_number": "234-214-9731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PHOENIX RECOVERY SUPPORT SERVICES AND SOBER LIVING ENVIRONMENTS LL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A",
        "authorized_official_last_name": "MCCREERY",
        "authorized_official_first_name": "KOREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT / OPERATIONS",
        "authorized_official_telephone_number": "234-214-9731"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Canton, OH
• Providers in Canton, OH by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.