NPIMap

Organization Active NPI

Phoenix Resolutions Treatment Facility

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Port Saint Lucie, FL
National Provider Identifier
1669858304
Registry record updated Aug 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
PHOENIX RESOLUTIONS TREATMENT FACILITY
Practice address
518 SW Prima Vista Blvd
Suite B
Port Saint Lucie, FL 34983-8734
Phone
(914) 584-2395
NPI assigned
Aug 5, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2015

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

Authorized official

Name
Mr. Roechard Ebanks
Title
Ceo
Phone
(914) 584-2395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

518 SW Prima Vista Blvd
Suite B
Port Saint Lucie, FL 34983-8734

Mailing address

518 SW Prima Vista Blvd
Suite B
Port Saint Lucie, FL 34983-8734
Phone (914) 584-2395

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Resolutions Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

518 SW Prima Vista Blvd
Ste B
Port Saint Lucie, FL 34983
Phone (914) 584-2395

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438732800000",
    "number": "1669858304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 SW PRIMA VISTA BLVD",
            "address_2": "SUITE B",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349838734",
            "telephone_number": "914-584-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 SW PRIMA VISTA BLVD",
            "address_2": "SUITE B",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349838734",
            "telephone_number": "914-584-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RESOLUTIONS TREATMENT FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-05",
        "last_updated": "2015-08-05",
        "status": "A",
        "authorized_official_last_name": "EBANKS",
        "authorized_official_first_name": "ROECHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "914-584-2395",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2015; 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.