Phoenix Recovery Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

29114900 Issued in WA

Legal business name

PHOENIX RECOVERY SERVICES, LLC

Practice address

1601 E College Way
Mount Vernon, WA 98273-5612

Phone

(360) 848-8437

Fax

(360) 848-5250

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Carol Ruth Hundahl, CDP

Title

Owner

Phone

(360) 848-8437

Specialties & licenses 1

Addresses

Tax ID family

Phoenix Recovery Services LLC2 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.

• Phoenix Recovery Services, LLC

  dba Phoenix Recovery Services, LLC, Island

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Oak Harbor, WA
  • NPI 1467763276
  NPD tax ID

Locations

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760506315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E COLLEGE WAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735612",
            "telephone_number": "360-848-8437",
            "fax_number": "360-848-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E COLLEGE WAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735612",
            "telephone_number": "360-848-8437",
            "fax_number": "360-848-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RECOVERY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUNDAHL",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-848-8437",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CDP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WA",
            "license": "29114900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Pfeiffer, RD
• Henning Pforte, MD
• Daniel Pham, MD
• Ken Luong Pham
• Phoenix Recovery House
• Phoenix Recovery Services, LLC
• Michael J. Picco, DO
• Gretchen Pickett
• Sandee Pierce, LMP
• Anna L Pilzek, MD

• Community/Behavioral Health Agency in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Community/Behavioral Health Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.