Phases Detox, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PHASES DETOX, LLC

Practice address

1870 Forest Hill Blvd
Suite 204
West Palm Beach, FL 33406-8901

Phone

(732) 910-1427

NPI assigned

May 9, 2017

Last updated

May 9, 2017By 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

Shane Kohan

Title

Owner

Phone

(732) 910-1427

Specialties & licenses 1

Addresses

Tax ID family

Phases Detox LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Phases Detox, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • West Palm Beach, FL
  • NPI 1396287264
  NPD tax ID

Locations

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

{
    "created_epoch": "1494288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494288000000",
    "number": "1265968408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 FRANKLIN RD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334054208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 FOREST HILL BLVD",
            "address_2": "SUITE 204",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334068901",
            "telephone_number": "732-910-1427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHASES DETOX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-09",
        "last_updated": "2017-05-09",
        "status": "A",
        "authorized_official_last_name": "KOHAN",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-910-1427"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khoa Pham, DPM
• Luan Dinh Pham, PHARMD
• Quynhnhu Pham, DDS, MS
• Danielson Pharaud
• Pharma 4.0 LLC
• Phases Detox, LLC
• Annemarie Phelan, MS, LMHC
• Francis E Phelps III, D.O.M
• Kathleen R Philbin, CNM
• Willy Philias, M.D.

• Substance Use Disorder Rehabilitation Clinic/Center in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; 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.