NPIMap

Organization Active NPI

Phoenix Health Services

  • Substance Abuse Rehabilitation Facility
  • Baltimore, MD
National Provider Identifier
1679259220
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
PHOENIX HEALTH SERVICES
Practice address
821 N Port St
Baltimore, MD 21205-1623
Phone
(443) 878-1111
NPI assigned
Jun 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Ms. Nicole Lively, MBA
Title
Coo
Phone
(443) 878-1111

Specialties & licenses 1

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

Addresses

Primary practice location

821 N Port St
Baltimore, MD 21205-1623

Mailing address

2115 N Charles St Ste 200
Baltimore, MD 21218-5751
Phone (443) 878-1111

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": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1679259220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 N CHARLES ST STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185751",
            "telephone_number": "443-878-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 N PORT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212051623",
            "telephone_number": "443-878-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "LIVELY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "443-878-1111",
        "authorized_official_name_prefix": "Ms.",
        "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 Jun 27, 2023; 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.