PHOENIX CENTER BEHAVIORAL HEALTH SERVICES (NPI# 1649424789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649424789 |
| Entity Type | Organization |
| Organization Name | PHOENIX CENTER BEHAVIORAL HEALTH SERVICES |
| Practice Address |
940 Highway 96 Ste A Warner Robins GA 31088-2587 |
| Practice Telephone | 4789881222 |
| Practice Fax Number | 4789881422 |
| Mailing Telephone | 4789881222 |
| Mailing Fax Number | 4789881422 |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-14 |
| Authorized Official Name | SHONTAON MICHELLE DEAN (LPN) |
| Authorized Official Telephone | 4789881222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | ========= | GA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 58215225 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PHOENIX CENTER BEHAVIORAL HEALTH SERVICES | 940 Highway 96, Warner Robins, GA 31088-2584 |
| Street Address |
940 HIGHWAY 96 STE A |
| City | WARNER ROBINS |
| State | GA |
| Zip Code | 31088-2587 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538313101 | Tracy Jones Marshall | Licensed Practical Nurse | 940 Highway 96 Ste A, Warner Robins, GA 31088-2587 | 2008-11-10 |
| 1235443169 | Gerald Nichole Hicks | Licensed Practical Nurse | 940 Highway 96 Ste A, Warner Robins, GA 31088-2587 | 2010-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218921 | Sarah Newman | Pharmacist | 1081 Ga-96, Warner Robins, GA 31088 | 2020-09-08 |
| 1619599115 | Alana Jane Sibley | Registered Nurse | 940 Ga - 96, Warner Robins, GA 31088 | 2020-05-07 |
| 1033779657 | Jodi Lynne Pettygrove | Nurse Practitioner | 115 Havelock Cir, Warner Robins, GA 31088 | 2019-06-17 |
| 1164994901 | Gwendolyn Jordan Taylor | Registered Nurse | 940-c Ga Hwy 96, Same, Warner Robins, GA 31088 | 2018-12-18 |
| 1447721543 | Amy Tanner | Behavioral Analyst | 200 Cresview Church Rd #1806, Warner Robins, GA 31088 | 2018-12-16 |
| 1518435676 | Phoenix Health Center | Case Management | 940 Ga-96, Warner Robins, GA 31088 | 2018-11-07 |
| 1427534320 | Jared Dean Johnson | Social Worker | 146 Lakepointe Drive, Warner Robins, GA 31088 | 2018-07-13 |
| 1285124180 | Cmp Academy & Billing Service | Contractor | 105 S Commercial Circle, Warner Robins, GA 31088 | 2018-05-16 |
| 1730692377 | Benzer Pharmacy | Pharmacy | 150 S Houston Lake Rd Ste 300, Warner Robins, GA 31088 | 2017-11-06 |
| 1821507476 | Timothy Doyle Thomas | Registered Nurse | 940-c Hwy 96, Warner Robins, GA 31088 | 2017-09-27 |
| Find all providers in zip 31088 | ||||
| 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 |
|---|---|---|---|---|
| 1417561747 | Georgia Regional Health LLC | Community Based Residential Treatment Facility, Mental Illness | 1211 Waterville Ct, Alpharetta, GA 30022-5381 | 2020-09-03 |
| 1275161192 | Monte Nido Georgia LLC | Community Based Residential Treatment Facility, Mental Illness | 124 Johnson Ferry Rd Ne, Sandy Springs, GA 30328-3004 | 2020-03-27 |
| 1811464035 | Hope Homes Recovery, LLC | Community Based Residential Treatment Facility, Mental Illness | 432 Virginia Rd, Atlanta, GA 30338-4793 | 2018-10-25 |
| 1770066029 | New Beginnings PCh of Columbus, LLC | Community Based Residential Treatment Facility, Mental Illness | 639 Lawyers Ln, Columbus, GA 31906-3812 | 2018-09-12 |
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1326555210 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 101, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1245747138 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 104, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1235646217 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 401, Riverdale, GA 30274-1502 | 2017-12-29 |
| 1528574431 | House of Concrete Roses, LLC | Community Based Residential Treatment Facility, Mental Illness | 1133 Huff Rd Nw Apt 766, Atlanta, GA 30318-4327 | 2017-12-15 |
| 1508391756 | Mister Life Coach | Community Based Residential Treatment Facility, Mental Illness | 3681 N Decatur Rd Apt R11, Decatur, GA 30032-1062 | 2017-04-25 |
| Find all providers with the same taxonomy | ||||
| City | WARNER ROBINS |
| Zip Code | 31088 |
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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.