Phoenix House Foundation

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

414715-1 Issued in NY

Legal business name

PHOENIX HOUSE FOUNDATION

Practice address

3411 Vernon Blvd
Long Island City, NY 11106-5121

Phone

(718) 726-8484

NPI assigned

Dec 7, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Joyce Lorraine Bernabo, RN

Title

RN

Phone

(718) 726-8484

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790844520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9328 85TH RD",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114211418",
            "telephone_number": "718-846-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 VERNON BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111065121",
            "telephone_number": "718-726-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERNABO",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "718-726-8484",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NY",
            "license": "414715-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Petersen
• John Phair, MD
• Minh Tam Pham, PA-C
• Neethu Philips
• Erica G. Phillips, MD, MS
• Alexandra Picault, RN
• Nina Picciano
• Ashley Pichardo, LMHC
• Elodie Pierre-Louis, RN
• Ester Pierre-Louis

• Substance Abuse Rehabilitation Facility in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Substance Abuse Rehabilitation Facility in New York

• 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.