Phoenix Treatment Centers Outpatient Division, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PHOENIX TREATMENT CENTERS OUTPATIENT DIVISION, LLC

Practice address

400 Venters LN Ste 100
Pikeville, KY 41501-3016

Phone

(606) 653-1505

NPI assigned

Sep 5, 2023

Organization subpart

Yes

Parent organization

PHOENIX TREATMENT CENTERS, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Amber Sisco

Title

Owner

Phone

(606) 367-3980

Specialties & licenses 2

Addresses

Part of

Phoenix Treatment Centers LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Phoenix Treatment Centers, LLC

  • Substance Abuse Rehabilitation Facility
  • Pikeville, KY
  • NPI 1770264749
  NPPES parent name

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

{
    "created_epoch": "1693872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711152000000",
    "number": "1699551754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1285",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415021285",
            "telephone_number": "606-658-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VENTERS LN STE 100",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013016",
            "telephone_number": "606-653-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX TREATMENT CENTERS OUTPATIENT DIVISION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX TREATMENT CENTERS, LLC",
        "enumeration_date": "2023-09-05",
        "last_updated": "2024-03-23",
        "certification_date": "2024-03-23",
        "status": "A",
        "authorized_official_last_name": "SISCO",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-367-3980",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Pekel
• Al Pelphrey, D.M.D.
• Sandra Perry, CRNA
• Nikki Petterson
• Caitlin McKenzie Phillips, RBT
• Phoenix Treatment Centers, LLC
• Physical Therapy Clinic PSC (Pike County Physical Therapy Clinic, PSC)
• Physicians for Children & Adolescents PSC
• Physicians for Children & Adolescents PSC (Physicians For Children)
• Alondra Pichardo

• Substance Use Disorder Rehabilitation Clinic/Center in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2024; 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.