Phoenix Recovery Center, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

PHOENIX RECOVERY CENTER, LLC

Practice address

1224 Jersey St
Conway, AR 72032-4658

Phone

(501) 499-6696

Fax

(501) 499-6639

NPI assigned

Feb 25, 2015

Last updated

Feb 25, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Ferguson Bell

Title

Executive Director

Phone

(501) 539-1501

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine Elfrida Seidl, LMSW

  • Clinical Social Worker
  • Little Rock, AR
  • NPI 1215320544
  NPD (past)

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

{
    "created_epoch": "1424822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424822400000",
    "number": "1932591187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 JERSEY ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324658",
            "telephone_number": "501-499-6696",
            "fax_number": "501-499-6639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 JERSEY ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324658",
            "telephone_number": "501-499-6696",
            "fax_number": "501-499-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RECOVERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-25",
        "last_updated": "2015-02-25",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "FERGUSON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "501-539-1501",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Brian Phillips, LMT
• Kathleen E. Phillips, M.S., CCC-A
• Katrina Donnielle Phillips
• Sydney M Phillips
• Johann Philmon, RECOVERY ASSISTANT
• Physical Therapy Specialists of Coway
• Gracie Pickens
• Donaven Pickren
• Tequlia Monikia Pickrom, LMSW
• Margaret L Pierce, APRN

• Substance Abuse Rehabilitation Facility in Conway, AR
• Providers in Conway, AR by specialty
• Substance Abuse Rehabilitation Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.