Active NPI
Phoenix Programs, Inc.
- Substance Use Disorder Rehabilitation Clinic/Center
- Columbia, MO
National Provider Identifier
1912354572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/Center
- Legal business name
- PHOENIX PROGRAMS, INC.
- Doing business as
- Phoenix Health Programs
- Practice address
- 90 E Leslie LN
Columbia, MO 65202-1535 - Phone
- (573) 875-8880
- Fax
- (573) 442-3830
- NPI assigned
- May 24, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Laura L Cameron, RASAC II
- Title
- Veterans Specialist
- Phone
- (573) 875-8880
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | MO | Primary |
Addresses
Primary practice location
90 E Leslie LN
Columbia, MO 65202-1535
Mailing address
90 E Leslie Lane
Columbia, MO 65202
Phone (573) 875-8880
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265757991 | Medicaid | MO | |
| 866476609 | Medicaid | MO | |
| 1437213634 | Medicaid | MO |
Other names 1
- Phoenix Health Programs
National Provider Directory
National Provider Directory- Tax ID family
- Phoenix Health Programs
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Abuse Rehabilitation Facility
- Columbia, MO
- NPI 1265757991
-
- Substance Abuse Rehabilitation Facility
- Columbia, MO
- NPI 1437213634
-
- Professional Counselor
- Columbia, MO
- NPI 1851873608
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1464048000000",
"number": "1912354572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 E LESLIE LANE",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65202",
"telephone_number": "573-875-8880",
"fax_number": "573-442-3830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 E LESLIE LN",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652021535",
"telephone_number": "573-875-8880",
"fax_number": "573-442-3830"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHOENIX PROGRAMS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2016-05-24",
"last_updated": "2016-05-24",
"status": "A",
"authorized_official_last_name": "CAMERON",
"authorized_official_first_name": "LAURA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "VETERANS SPECIALIST",
"authorized_official_telephone_number": "573-875-8880",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RASAC II"
},
"taxonomies": [
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "MO",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1265757991",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "866476609",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437213634",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Phoenix Health Programs",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.