NPIMap

Organization Active NPI

Phoenix Homes #2

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Raleigh, NC
National Provider Identifier
1679707574
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
MHL-092-741 Issued in NC
Legal business name
PHOENIX HOMES #2
Practice address
5628 Millrace TRL
Raleigh, NC 27606-9227
Phone
(919) 522-9896
Fax
(919) 231-1456
NPI assigned
May 6, 2009
Last updated
May 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2009

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

Authorized official

Name
Mr. Lotanna Omeze Nwankwo
Title
Director/Administrator
Phone
(919) 522-9896

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X MHL-092-741 NC Primary

Addresses

Primary practice location

5628 Millrace TRL
Raleigh, NC 27606-9227

Mailing address

5628 Millrace TRL
Raleigh, NC 27606-9227
Phone (919) 522-9896

National Provider Directory

National Provider Directory
Tax ID family
Champion Healthcare 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.

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241568000000",
    "number": "1679707574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5628 MILLRACE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276069227",
            "telephone_number": "919-522-9896",
            "fax_number": "919-231-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5628 MILLRACE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276069227",
            "telephone_number": "919-522-9896",
            "fax_number": "919-231-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOMES #2",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "LOTANNA",
        "authorized_official_middle_name": "OMEZE",
        "authorized_official_title_or_position": "DIRECTOR/ADMINISTRATOR",
        "authorized_official_telephone_number": "919-522-9896",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "MHL-092-741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2009; 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.