Phoenix Domus

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PHOENIX DOMUS

Practice address

114 Beech Ave
Altoona, PA 16601-4235

Phone

(814) 502-5157

NPI assigned

Apr 5, 2021

Last updated

Jun 24, 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

Mr. Gregory Alan McConnell, B.S., M.ED., CHES

Title

Program Manager

Phone

(814) 934-6513

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782259200000",
    "number": "1336728724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 BEECH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014235",
            "telephone_number": "814-502-5157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BEECH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014235",
            "telephone_number": "814-502-5157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX DOMUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A",
        "authorized_official_last_name": "MCCONNELL",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "814-934-6513",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.S., M.ED., CHES"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077037",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peter Cong Pham, DDS
• Thomas Pham, MD
• Khadia M Phillip, M.D.
• Zoe R Phillips Connacher, O.D.
• Crystal Phillips, MS
• Phoenix Rehabilitation and Health Services, Inc.
• Physical, Rehabilitation, Industrial and Sports Medicine
• Rachael Piccione
• Ashley Pierce
• Tamara Pierce, MSLP/L

• Substance Abuse Rehabilitation Facility in Altoona, PA
• Providers in Altoona, PA by specialty
• Substance Abuse Rehabilitation Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.