NPIMap

Organization Active NPI

Phoenix Behavioral Health LLC

  • In Home Supportive Care Agency
  • Ewing, NJ
National Provider Identifier
1275938193
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PHOENIX BEHAVIORAL HEALTH LLC
Practice address
1014 Whitehead Road Ext
Ewing, NJ 08638-2406
Phone
(609) 771-3777
Fax
(609) 771-8041
NPI assigned
Nov 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Mr. Uriel Feldman, LSW
Title
Executive Director
Phone
(732) 581-6067

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X NJ Primary
Adult Mental Health Clinic/Center 261QM0850X NJ

Addresses

Primary practice location

1014 Whitehead Road Ext
Ewing, NJ 08638-2406

Mailing address

1014 Whitehead Road Ext
Ewing, NJ 08638-2406
Phone (609) 771-3777

Other identifiers 1

IdentifierTypeStateIssuer
0439673MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Behavioral Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1275938193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 WHITEHEAD ROAD EXT",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086382406",
            "telephone_number": "609-771-3777",
            "fax_number": "609-771-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 WHITEHEAD ROAD EXT",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086382406",
            "telephone_number": "609-771-3777",
            "fax_number": "609-771-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "FELDMAN",
        "authorized_official_first_name": "URIEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "732-581-6067",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NJ",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NJ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0439673",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ewing, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.