NPIMap

Organization Active NPI

Phoenix Nest Home, Inc

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Ruskin, FL
National Provider Identifier
1669313003
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
PHOENIX NEST HOME, INC
Practice address
10203 Count Fleet Dr
Ruskin, FL 33573-6774
Phone
(813) 843-4645
Fax
(813) 448-1237
NPI assigned
Apr 1, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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

Authorized official

Name
Diana Anioce-Andre, LMHCNPI 1336686575
Title
Clinical Director
Phone
(813) 843-4645

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Meals Provider 174200000X
Lodging Provider 177F00000X
Voluntary or Charitable Agency 251V00000X
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X Primary

Addresses

Primary practice location

10203 Count Fleet Dr
Ruskin, FL 33573-6774

Mailing address

10203 Count Fleet Dr
Ruskin, FL 33573-6774
Phone (813) 843-4645

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1669313003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10203 COUNT FLEET DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736774",
            "telephone_number": "813-843-4645",
            "fax_number": "813-448-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10203 COUNT FLEET DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736774",
            "telephone_number": "813-843-4645",
            "fax_number": "813-448-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX NEST HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-01",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "ANIOCE-ANDRE",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "813-843-4645",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruskin, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.