Phoenix Home for Boys

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

MHL-012-009 Issued in NC

Legal business name

PHOENIX HOME FOR BOYS

Practice address

117 William Parks LN
Morganton, NC 28655-9173

Phone

(828) 584-1589

Fax

(828) 584-1589

NPI assigned

Aug 5, 2007

Organization subpart

Yes

Parent organization

PHOENIX GROUP HOMES, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Ronda Mitchell Bythewood

Title

Executive Director

Phone

(828) 439-9911

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Phoenix Home for Girls2 organizations share this tax ID, including this one

Part of

Phoenix Home for Girls

Other organizations with this tax ID 1

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

• Phoenix Home for Girls

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Morganton, NC
  • NPI 1689738361
  NPD tax ID

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1588855787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2386",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286802386",
            "telephone_number": "828-439-9911",
            "fax_number": "828-439-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 WILLIAM PARKS LN",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286559173",
            "telephone_number": "828-584-1589",
            "fax_number": "828-584-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOME FOR BOYS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX GROUP HOMES, INC.",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "BYTHEWOOD",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "828-439-9911",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL-012-009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603042",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lam Ngoc Pham, MD
• Pharmacy of J Iverson Riddle Development Center (J Iverson Riddle Development Center)
• Bethany Dorcas Phelps, MA, LPC
• Mitzi Elaine Phillips, PTA
• Phoenix Counseling Center
• Phoenix Home for Girls
• Sara Lewis Piercy, FNP
• Christian Piers, D.D.S., M.S.
• Susan Chitty Pitts, R.PH
• Play Again Therapy Inc

• Emotionally Disturbed Childrens' Residential Treatment Facility in Morganton, NC
• Providers in Morganton, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.