NPIMap

Organization Active NPI

Phoenix Bridge Group Homes, Inc.

  • Case Management Agency
  • Burlington, NC
National Provider Identifier
1669514725
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
PHOENIX BRIDGE GROUP HOMES, INC.
Practice address
3309 N NC Highway 49 # a
Burlington, NC 27217-8589
Phone
(336) 578-0540
Fax
(336) 222-8533
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Miss Wendy Renee Jones
Title
Program Manager
Phone
(336) 222-8522

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL 001-120 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL 001-100 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL 001-121 NC
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X MHL -001 - 135 NC

Addresses

Primary practice location

3309 N NC Highway 49 # a
Burlington, NC 27217-8589

Mailing address

120 S Main St
Graham, NC 27253-2808
Phone (336) 222-8522

Other identifiers 5

IdentifierTypeStateIssuer
6603578MedicaidNC
8301363MedicaidNC
6603321MedicaidNC
6603357MedicaidNC
6603972MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Bridge Community Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

3309 N NC Highway 49
#A
Burlington, NC 27217
Phone (336) 578-0540

120 S Main St
Graham, NC 27253
Phone (704) 324-3617

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1669514725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S MAIN ST",
            "city": "GRAHAM",
            "state": "NC",
            "postal_code": "272532808",
            "telephone_number": "336-222-8522",
            "fax_number": "336-222-8533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 N NC HIGHWAY 49 # A",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272178589",
            "telephone_number": "336-578-0540",
            "fax_number": "336-222-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX BRIDGE GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "336-222-8522",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL 001-120",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL 001-100",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL 001-121",
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": "MHL -001 - 135",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603578",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301363",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603321",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603357",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6603972",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.