PHOENIX SUPPORTED LIVING INC (NPI# 1174679948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174679948 |
| Entity Type | Organization |
| Organization Name | PHOENIX SUPPORTED LIVING INC |
| Practice Address |
140 Adams Drive Andrews NC 28904 |
| Mailing Address |
2996 Nc 69 S. Suite 6 Hayesville NC 28904 |
| Practice Telephone | 8283891795 |
| Practice Fax Number | 8283891658 |
| Mailing Telephone | 8283891795 |
| Mailing Fax Number | 8283891658 |
| Enumeration Date | 2007-01-26 |
| 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 | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 7805326 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 7805326 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013053255 | Phoenix Supported Living Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 48 Britian Trace, Andrews, NC 28901 | 2007-01-29 |
| 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 |
| 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 |
140 ADAMS DRIVE |
| City | ANDREWS |
| State | NC |
| Zip Code | 28904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710537014 | Western Nc Home Care, LLC | Home Health | 164 Us-64, Hayesville, NC 28904 | 2019-09-18 |
| 1710405501 | Kristin Lyvers | Lactation Consultant, Non-RN | 602 Old Highway 64 W, Hayesville, NC 28904 | 2017-08-31 |
| 1679979629 | Rhonda Sue Schlienger | Family Medicine | 450 Us-64 Bus #4, Hayesville, NC 28904 | 2014-11-18 |
| 1053710947 | Michelle Radford | Case Manager/Care Coordinator | 2465 Eagle Fork Road, Hayesville, NC 28904 | 2014-08-18 |
| 1013140938 | Ingles Markets Inc | Pharmacy | 230 Hwy 64 E, Hayesville, NC 28904 | 2009-08-26 |
| 1336316512 | Hayesville Pharmacy LLC | Pharmacy | 808 Nc Hwy 69, Hayesville, NC 28904 | 2008-05-15 |
| 1427225036 | Anne Young Baldwin | Counselor | 875 Highway 64 Business, Suite 101, Hayesville, NC 28904 | 2008-05-13 |
| 1144415670 | Edward Carl Oconnor | Dentist | 36 Waldroup Road, Hayesville, NC 28904 | 2007-09-07 |
| 1679773485 | Hayesville House, LLC | Alzheimer Center (Dementia Center) | 480 Old 64 West, Hayesville, NC 28904 | 2007-07-19 |
| 1821292798 | Robert Turner Guidry | Psychologist | 46 Church St., Hayesville, NC 28904 | 2007-06-13 |
| Find all providers in zip 28904 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1912052085 | Phoenix Supported Living Inc | Community Based Residential Treatment Facility, Mental Illness | 140 Adams Dr, Andrews, NC 28901-8105 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041667 | Jalisa Jackson | Community Based Residential Treatment Facility, Mental Illness | 11413 Mangla Dr, Charlotte, NC 28214-8885 | 2020-10-19 |
| 1245837061 | Bliss Haven Group LLC | Community Based Residential Treatment Facility, Mental Illness | 2442 Sandhurst Ct, Gastonia, NC 28054-2738 | 2020-10-05 |
| 1386259265 | Nevaehs Caring Hands | Community Based Residential Treatment Facility, Mental Illness | 2509 Dalton Rd, Rocky Mount, NC 27803-4721 | 2020-09-09 |
| 1588279442 | C & C Homecare, LLC | Community Based Residential Treatment Facility, Mental Illness | 5119 Holdens Cross Rd, Wilson, NC 27893-8253 | 2020-09-08 |
| 1801409859 | Destiny & Miracle LLC | Community Based Residential Treatment Facility, Mental Illness | 1024 Houston St, Gastonia, NC 28052-1632 | 2020-08-28 |
| 1699329433 | Fresh Start Today Inc | Community Based Residential Treatment Facility, Mental Illness | 3707 Roseheim Ct, Greensboro, NC 27405-4867 | 2019-07-30 |
| 1003460833 | Care-in-full | Community Based Residential Treatment Facility, Mental Illness | 1338 Sharp Ridge Rd, Greensboro, NC 27406-8597 | 2019-07-30 |
| 1366001976 | Foundation of Hope, Inc. | Community Based Residential Treatment Facility, Mental Illness | 119 Grice Road, Chadbourn, NC 28431-6709 | 2019-06-07 |
| 1558927590 | Tall Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1915 Hasty Rd, Marshville, NC 28103-0029 | 2019-05-15 |
| 1174187868 | Stepping Stone Services Inc. | Community Based Residential Treatment Facility, Mental Illness | 2720 White Oak Ln, Kannapolis, NC 28083-7256 | 2019-04-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PHOENIX SUPPORTED LIVING INC.
| 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.