NPIMap

Organization Active NPI

Phoenix Recovery House

  • Community/Behavioral Health Agency
  • Mount Vernon, WA
National Provider Identifier
1285193979
Registry record updated Mar 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PHOENIX RECOVERY HOUSE
Practice address
1601 E College Way
Mount Vernon, WA 98273-5612
Phone
(360) 848-8437
NPI assigned
Mar 13, 2019
Last updated
Mar 13, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
PIONEER HUMAN SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2019

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

Authorized official

Name
Mr. Robert Dennis Sullivan, CDP, LICSW
Title
Director III
Phone
(360) 848-8437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1601 E College Way
Mount Vernon, WA 98273-5612

Mailing address

7440 W Marginal Way S
Seattle, WA 98108-4141

National Provider Directory

National Provider Directory
Tax ID family
Pioneer Center North35 organizations share this tax ID, including this one
Part of
Pioneer Center North

Other organizations with this tax ID 34

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

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552435200000",
    "number": "1285193979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7440 W MARGINAL WAY S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981084141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E COLLEGE WAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735612",
            "telephone_number": "360-848-8437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RECOVERY HOUSE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PIONEER HUMAN SERVICES",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "DIRECTOR III",
        "authorized_official_telephone_number": "360-848-8437",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CDP, LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.