PHOENIX HOUSE FOUNDATION (NPI# 1790844520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790844520 |
| Entity Type | Organization |
| Organization Name | PHOENIX HOUSE FOUNDATION |
| Practice Address |
3411 Vernon Blvd Long Island City NY 11106-5121 |
| Mailing Address |
9328 85th Rd Woodhaven NY 11421-1418 |
| Practice Telephone | 7187268484 |
| Mailing Telephone | 7188468187 |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. JOYCE LORRAINE BERNABO (RN) |
| Authorized Official Telephone | 7187268484 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 414715-1 | NY | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639506520 | Phoenix House Foundation | Substance Abuse Rehabilitation Facility | 11600 Eldridge Ave, Lake View Terrace, CA 91342-6506 | 2013-10-09 |
| 1013255769 | Phoenix House Foundation | Clinic/Center | 164 W 74th St, New York, NY 10023-2301 | 2013-01-30 |
| 1336464965 | Phoenix House Foundation | Substance Abuse Rehabilitation Facility | 998 Crooked Hill Rd, Building 5, Brentwood, NY 11717-1019 | 2010-04-07 |
| Street Address |
3411 VERNON BLVD |
| City | LONG ISLAND CITY |
| State | NY |
| Zip Code | 11106-5121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144830233 | Rebecca Elfriede Doyle | Nurse Practitioner | 3411 Vernon Blvd, Long Island City, NY 11106-5121 | 2020-08-04 |
| 1952813727 | Fallon Andrea Cunningham | Dentist | 3411 Vernon Blvd, Long Island City, NY 11106-5121 | 2017-11-01 |
| 1619415288 | Damian Family Care Center, Inc. | Clinic/Center | 3411 Vernon Blvd, Long Island City, NY 11106-5121 | 2017-02-03 |
| 1639239494 | Amy Phillips | Physician Assistant | 3411 Vernon Blvd, Long Island City, NY 11106-5121 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700492303 | Faizal Hussein | Physical Therapist | 3244 31st Street, Queens, NY 11106 | 2020-09-18 |
| 1730706086 | Stephanie J Coleman | Counselor | Enable My Child, 3545 28 St, Astoria, NY 11106 | 2020-07-02 |
| 1144870056 | Theresa Pizinger | Nurse Practitioner | 3157 31st St, Phf, Long Island City, NY 11106 | 2019-09-13 |
| 1881164564 | Adam Christopher Maslowski | Social Worker | 34-11 Vernon Blvd., Long Island City, NY 11106 | 2018-11-26 |
| 1730675273 | Astoria Dental Broadway | Dentist | 31-72 31st St, Suite #1, Astoria, NY 11106 | 2018-07-09 |
| 1225552037 | Joslynn Ramos | Social Worker | 14-15 Broadway, Astoria, NY 11106 | 2017-08-02 |
| 1790208791 | Sheilla Jean Baptiste Hadid | Prevention Professional | 34 59 Vernon Blvd Apt 1f, Astoria, NY 11106 | 2017-07-21 |
| 1396267225 | Serena Cisneros | Counselor | 34-25 Vernon Blvd, Long Island City, NY 11106 | 2017-07-12 |
| 1538689302 | Dara Michelle Lazar | Massage Therapist | 14-17 31st Avenue, Apt 2b, Astoria, NY 11106 | 2017-06-22 |
| 1093241143 | Kimlong Chan | Student in an Organized Health Care Education/Training Program | 2320 31st Avenue, Astoria, NY 11106 | 2017-05-11 |
| Find all providers in zip 11106 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104923291 | Q.s.a Services Inc. | Substance Abuse Rehabilitation Facility | 3501 Queens Blvd, Long Island City, NY 11101-1700 | 2006-09-20 |
| 1437544186 | Craig Williams | Substance Abuse Rehabilitation Facility | 2976 Northern Blvd, Long Island City, NY 11101-2822 | 2015-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992337224 | Council On Addiction Recovery Services, Inc. | Substance Abuse Rehabilitation Facility | 1355 Olean-portville Road, Westons Mills, NY 14788-1476 | 2020-02-05 |
| 1528609799 | Ebdk At Calverton | Substance Abuse Rehabilitation Facility | 525 Jan Way, Calverton, NY 11933-3005 | 2019-09-30 |
| 1124679998 | Resource Recovery Center of Orange County LLC | Substance Abuse Rehabilitation Facility | 68 Crystal Run Rd, Middletown, NY 10941-7100 | 2019-09-24 |
| 1326506064 | Mountainside - Huntington | Substance Abuse Rehabilitation Facility | 141 E Main St Ste 2, Huntington, NY 11743-2850 | 2019-03-12 |
| 1023589090 | Argus Community, Inc. | Substance Abuse Rehabilitation Facility | 2015-25 Madison Avenue, 4th Floor, New York, NY 10035-1015 | 2018-12-16 |
| 1578030797 | Hope House, Inc. | Substance Abuse Rehabilitation Facility | 577 Livingston Ave, Albany, NY 12206-2408 | 2018-10-25 |
| 1467949867 | Ocean Recovery East LLC | Substance Abuse Rehabilitation Facility | 113 E 60th St, New York, NY 10022-1939 | 2018-04-20 |
| 1578050944 | Elev8 Center New York, LLC | Substance Abuse Rehabilitation Facility | 151 W 136th St, New York, NY 10030-2606 | 2018-04-20 |
| 1518491174 | Aaron Smith | Substance Abuse Rehabilitation Facility | 460 Brielle Ave, Building H, Staten Island, NY 10314 | 2017-04-20 |
| 1346772019 | Catholic Charities of The Diocese of Rockville Centre | Substance Abuse Rehabilitation Facility | 30 Carlough Rd Ste C, Bohemia, NY 11716-2919 | 2017-03-31 |
| Find all providers with the same taxonomy | ||||
| City | LONG ISLAND CITY |
| Zip Code | 11106 |
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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.