PHOENIX HOME CARE, INC (NPI# 1003382680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003382680 |
| Entity Type | Organization |
| Organization Name | PHOENIX HOME CARE, INC |
| Other Organization Name | PHOENIX HOME CARE AND HOSPICE |
| Practice Address |
3033 S Kansas Expy Springfield MO 65807-5969 |
| Practice Telephone | 4178817442 |
| Practice Fax Number | 4178897442 |
| Mailing Telephone | 4178817442 |
| Mailing Fax Number | 4178897442 |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |
| Authorized Official Name | MS. GWEN R. BEEBE (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Telephone | 4178383000 |
| Authorized Official Credential | BS, MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | MO | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 8500 | 05 |
| Other Name | Type Code |
|---|---|
| Phoenix Home Care and Hospice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811375868 | Phoenix Home Care, Inc | Hospice Care, Community Based | 3033 S Kansas Expy, Springfield, MO 65807-5969 | 2015-05-11 |
| 1295064400 | Phoenix Home Care, Inc | Home Health | 10330 N Dale Mabry Hwy, Suite 220, Tampa, FL 33618-4404 | 2009-12-17 |
| 1205074077 | Phoenix Home Care, Inc | Home Health | 50 W Oak St, Kissimmee, FL 34741-4416 | 2009-01-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PHOENIX HOME CARE, INC. | 271 Amherst Street, Brooklyn, New York 11235 |
| Street Address |
3033 S KANSAS EXPY |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336437623 | Phoenix Home Care Inc | Home Health | 3033 S Kansas Expy, Springfield, MO 65807-5969 | 2011-07-20 |
| 1821614553 | Phoenix Therapy Services, LLC | Clinic/Center | 3033 S Kansas Expy, Springfield, MO 65807-5969 | 2020-06-18 |
| 1750894366 | Phoenix Home Care Inc | Home Health | 3033 S Kansas Expy, Springfield, MO 65807-5969 | 2017-11-06 |
| 1881116077 | Phoenix Home Care, Inc. | Home Health | 3033 S Kansas Expy, Springfield, MO 65807-5969 | 2017-07-10 |
| 1811375868 | Phoenix Home Care, Inc | Hospice Care, Community Based | 3033 S Kansas Expy, Springfield, MO 65807-5969 | 2015-05-11 |
| 1235516618 | Phoenix Home Care Inc | Hospice Care, Community Based | 3033 S Kansas Expy, Springfield, MO 65807-5969 | 2015-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659993079 | Collaborative Community LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6000 Filbert Ct, Springfield, VA 22152-1609 | 2020-05-07 |
| 1598306904 | Hearo Technologies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 405 N Jefferson Ave Ste 1063, Springfield, MO 65806-1110 | 2019-10-07 |
| 1144685785 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 58 Shelburne Rd, Springfield, PA 19064-2206 | 2015-12-28 |
| 1912362088 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 524 Kerr Ln, Springfield, PA 19064-1616 | 2015-12-16 |
| 1558726620 | Divine Providence Village | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 139 N Hillcrest Rd, Springfield, PA 19064-1441 | 2015-12-16 |
| 1386029072 | Preferred Family Healthcare, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2646 W Olive St, Apt A, Springfield, MO 65802-4620 | 2015-07-23 |
| 1104200096 | The Arc of Union County | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 43 Baltusrol Way, Springfield, NJ 07081-1503 | 2015-07-10 |
| 1558742940 | Community Action for Independent Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 162 Bryant Ave, Springfield, NJ 07081-1615 | 2015-06-11 |
| 1790177467 | Community Action for Independent Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Cornell Pkwy, Springfield, NJ 07081-3561 | 2015-03-04 |
| 1932546702 | Behavioral Learning Center, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 230 N Belcrest Ave, Suite B, Springfield, MO 65802-6288 | 2013-06-03 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.