NPIMap

Organization Active NPI

Phoenix Health Services

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1437861630
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
PHOENIX HEALTH SERVICES
Practice address
3602 Mohawk Ave
Baltimore, MD 21207-7665
Phone
(443) 631-3303
NPI assigned
Dec 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Nicole Lively, MBA
Title
Coo
Phone
(443) 631-3303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

3602 Mohawk Ave
Baltimore, MD 21207-7665

Mailing address

5616 Park Heights Ave
Baltimore, MD 21215-3969
Phone (443) 631-3303

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Health Services17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1437861630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 PARK HEIGHTS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153969",
            "telephone_number": "443-631-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3602 MOHAWK AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212077665",
            "telephone_number": "443-631-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-19",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "LIVELY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "443-631-3303",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.