PHOENIX SUPPORTED LIVING INC (NPI# 1013053255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013053255 |
| Entity Type | Organization |
| Organization Name | PHOENIX SUPPORTED LIVING INC |
| Practice Address |
48 Britian Trace Andrews NC 28901 |
| Mailing Address |
2996 Nc 69 Suite 6 Hayesville NC 28904-7257 |
| Practice Telephone | 8283891795 |
| Practice Fax Number | 8283891658 |
| Mailing Telephone | 8283891795 |
| Mailing Fax Number | 8283891658 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JANET MELISSA NEMKOVICH (DIRECTOR) |
| Authorized Official Telephone | 8283891795 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8300925 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300925 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457497687 | Phoenix Supported Living Inc | Residential Treatment Facility, Physical Disabilities | 201 Hampton Church Road, Murphy, NC 28906 | 2007-01-29 |
| 1487700258 | Phoenix Supported Living Inc | Community Based Residential Treatment Facility, Mental Illness | 19645 Us 19, Andrews, NC 28901 | 2007-01-26 |
| 1174679948 | Phoenix Supported Living Inc | Community Based Residential Treatment Facility, Mental Illness | 140 Adams Drive, Andrews, NC 28904 | 2007-01-26 |
| 1073669818 | Phoenix Supported Living Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 284 Smokeford Rd, Murphy, NC 28906-9065 | 2007-01-26 |
| 1356497127 | Phoenix Supported Living Inc | Residential Treatment Facility, Physical Disabilities | 284 Smokeford Road, Murphy, NC 28906 | 2007-01-26 |
| 1942356779 | Phoenix Supported Living Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 205 Hampton Church Road, Murphy, NC 28906 | 2007-01-26 |
| 1912052085 | Phoenix Supported Living Inc | Community Based Residential Treatment Facility, Mental Illness | 140 Adams Dr, Andrews, NC 28901-8105 | 2007-01-25 |
| 1366598336 | Phoenix Supported Living Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 48 Brittian Trace, Andrews, NC 28901 | 2007-01-25 |
| 1437204674 | Phoenix Supported Living Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 201 Hampton Church Rd, Murphy, NC 28906-8323 | 2007-01-25 |
| 1033298864 | Phoenix Supported Living Inc | Assisted Living Facility | 2996 Nc 69 S, Suite #6, Hayesville, NC 28904 | 2006-11-03 |
| Street Address |
48 BRITIAN TRACE |
| City | ANDREWS |
| State | NC |
| Zip Code | 28901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992348601 | April Sue Turner | Nurse Practitioner | 2751 Us-19 Bus, Andrews, NC 28901 | 2019-10-25 |
| 1841753290 | Paula Hall | Speech-Language Pathologist | 2742 Fairview Rd, Andrews, NC 28901 | 2019-04-12 |
| 1336491307 | Davidson Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 19704 Highway 19, Andrews, NC 28901 | 2012-10-15 |
| 1942479100 | Whispering Pines Family Care Home | Assisted Living Facility | 11 Piercy Rd, Andrews, NC 28901 | 2008-02-21 |
| 1730371303 | Carolina Care Homes Inc | Custodial Care Facility | 4025 Pisgah Rd, Andrews, NC 28901 | 2007-08-16 |
| 1598800880 | Cutshaw Chiropractic Center, Inc | Chiropractor | 13882 Us Hwy 19, Whites Plaza, Andrews, NC 28901 | 2007-02-21 |
| 1083750228 | Phoenix Supported Living Inc. | Community Based Residential Treatment Facility, Mental Illness | 19 645 Hwy 19, Andrews, NC 28901 | 2007-01-29 |
| 1487700258 | Phoenix Supported Living Inc | Community Based Residential Treatment Facility, Mental Illness | 19645 Us 19, Andrews, NC 28901 | 2007-01-26 |
| 1366598336 | Phoenix Supported Living Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 48 Brittian Trace, Andrews, NC 28901 | 2007-01-25 |
| 1871682583 | Andrews Family Chiropractic LLC | Chiropractor | 18 Town Branch Road, Andrews, NC 28901 | 2006-10-12 |
| Find all providers in zip 28901 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336491307 | Davidson Homes, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 19704 Highway 19, Andrews, NC 28901 | 2012-10-15 |
| 1366598336 | Phoenix Supported Living Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 48 Brittian Trace, Andrews, NC 28901 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578160552 | Residential Option Serving Adolescents, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2316 Carved Tree Ln, Charlotte, NC 28262-3154 | 2020-10-03 |
| 1649895442 | Gaynelle Bolling | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 102 Mandarin Dr, Pikeville, NC 27863-0020 | 2020-06-08 |
| 1851913966 | Johnson Enrichment Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 221 Foxcroft Dr, Winston Salem, NC 27103-5313 | 2020-05-12 |
| 1881230795 | Walter Jason Young Jr. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 412 Rook Rd, Charlotte, NC 28216-3199 | 2019-11-26 |
| 1750935839 | Heavenly Touch Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4720 Baileys Lake Rd Nw Apt 204, Concord, NC 28027-8576 | 2019-07-28 |
| 1073166245 | Making Kids Matter, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 409 Hunton Forest Dr Nw, Concord, NC 28027-0186 | 2019-07-17 |
| 1891357752 | New Hope for Tomorrow LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 528 Baldwin Rd, Burlington, NC 27217-1702 | 2019-07-01 |
| 1114490877 | Brenda Gail Cannon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3105 Vico Ter, Raleigh, NC 27610-5951 | 2019-01-05 |
| 1356813455 | Lamesha Marshall | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3335 Avalon Ave, Charlotte, NC 28208-3378 | 2018-12-31 |
| 1487131074 | Ronald Anthony Benjamin | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1594 Candace Ridge Dr, Greensboro, NC 27406-8595 | 2018-07-26 |
| Find all providers with the same taxonomy | ||||
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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.