Active NPI
Phoenix Houses of New England, Inc.
- Substance Abuse Rehabilitation Facility
- Providence, RI
National Provider Identifier
1992884787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Substance Abuse Rehabilitation Facility
- License
- CMC 00028
- Legal business name
- PHOENIX HOUSES OF NEW ENGLAND, INC.
- Practice address
- 99 Wayland Ave
Suite 100
Providence, RI 02906-4314 - Phone
- (401) 331-4250
- Fax
- (401) 421-5520
- NPI assigned
- Nov 3, 2006
- 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
- Mr. Peter Mumma
- Title
- President/ Ceo
- Phone
- (401) 331-4250
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | |||
| Psychiatry Physician | 2084P0800X | |||
| Addiction Psychiatry Physician | 2084P0802X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | 621 | RI | |
| Substance Abuse Rehabilitation Facility | 324500000X | CMC 00028 | RI | Primary |
| Substance Abuse Rehabilitation Facility | 324500000X | 02725 | NH | |
| Substance Abuse Rehabilitation Facility | 324500000X | 0296 | MA | |
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X | |||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | |||
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X |
Addresses
Primary practice location
99 Wayland Ave
Suite 100
Providence, RI 02906-4314
Mailing address
99 Wayland Ave
Suite 100
Providence, RI 02906-4314
Phone (401) 331-4250
Other identifiers 19
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410878 | Other | BC RI | |
| 9202 | Other | RI | NHP RI |
| 9515 | Other | RI | NHP RI |
| 15601000 | Other | ME | MAINECARE |
| 15601001 | Other | ME | MAINECARE |
| 203388 | Other | BC RI | |
| MA04867 | Medicaid | RI | |
| 6988 | Other | BC RI | |
| 30766 | Other | BC RI | |
| 1009585 | Medicaid | VT | |
| 1006554 | Medicaid | VT | |
| 1009358 | Medicaid | VT | |
| 410875 | Other | BC RI | |
| 9203 | Other | RI | NHP RI |
| 1002232 | Medicaid | VT | |
| 30007117 | Medicaid | NH | |
| 30763 | Other | BC RI | |
| 467656 | Other | MOHEGAN SUN VALUE OPTIONS | |
| 9192 | Other | RI | NHP RI |
National Provider Directory
National Provider Directory- Tax ID family
- Phoenix House
Other organizations with this tax ID 9
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Westerly, RI
- NPI 1841403136
-
- Community/Behavioral Health Agency
- Wakefield, RI
- NPI 1790804292
-
- Addiction (Substance Use Disorder) Counselor
- Wakefield, RI
- NPI 1952523417
-
- Substance Abuse Rehabilitation Facility
- Springfield, MA
- NPI 1023408309
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Springfield, MA
- NPI 1982929592
-
- Mental Illness Community Based Residential Treatment Facility
- Brattleboro, VT
- NPI 1093116071
-
- Substance Abuse Rehabilitation Facility
- Keene, NH
- NPI 1316310949
-
- Community/Behavioral Health Agency
- Keene, NH
- NPI 1437327939
-
- Substance Abuse Rehabilitation Facility
- Dublin, NH
- NPI 1356441141
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Pascoag, RI
- NPI 1588052070
-
- Mental Health Counselor
- Brattleboro, VT
- NPI 1447722186
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1617926400000",
"number": "1992884787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 WAYLAND AVE",
"address_2": "SUITE 100",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064314",
"telephone_number": "401-331-4250",
"fax_number": "401-421-5520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 WAYLAND AVE",
"address_2": "SUITE 100",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064314",
"telephone_number": "401-331-4250",
"fax_number": "401-421-5520"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHOENIX HOUSES OF NEW ENGLAND, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-03",
"last_updated": "2021-04-09",
"certification_date": "2021-04-09",
"status": "A",
"authorized_official_last_name": "MUMMA",
"authorized_official_first_name": "PETER",
"authorized_official_title_or_position": "PRESIDENT/ CEO",
"authorized_official_telephone_number": "401-331-4250",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0802X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Addiction Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "RI",
"license": "621",
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "RI",
"license": "CMC 00028",
"primary": true
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "NH",
"license": "02725",
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": "MA",
"license": "0296",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "364SP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC RI",
"identifier": "410878",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP RI",
"identifier": "9202",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP RI",
"identifier": "9515",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAINECARE",
"identifier": "15601000",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAINECARE",
"identifier": "15601001",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC RI",
"identifier": "203388",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MA04867",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC RI",
"identifier": "6988",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC RI",
"identifier": "30766",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009585",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1006554",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009358",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC RI",
"identifier": "410875",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP RI",
"identifier": "9203",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1002232",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30007117",
"state": "NH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC RI",
"identifier": "30763",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MOHEGAN SUN VALUE OPTIONS",
"identifier": "467656",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP RI",
"identifier": "9192",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.