PHOENIX RECOVERY CENTER, LLC (NPI# 1932591187) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932591187 |
| Entity Type | Organization |
| Organization Name | PHOENIX RECOVERY CENTER, LLC |
| Practice Address |
1224 Jersey St Conway AR 72032-4658 |
| Practice Telephone | 5014996696 |
| Practice Fax Number | 5014996639 |
| Mailing Telephone | 5014996696 |
| Mailing Fax Number | 5014996639 |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2015-02-25 |
| Authorized Official Name | MR. MATTHEW FERGUSON BELL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5015391501 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | AR | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275073553 | Phoenix Recovery Center, LLC | Family Medicine | 5945 Sawmill Rd, Dublin, OH 43017-1623 | 2017-03-06 |
| Street Address |
1224 JERSEY ST |
| City | CONWAY |
| State | AR |
| Zip Code | 72032-4658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215320544 | Katherine Elfrida Daves | Counselor | 1224 Jersey St, Conway, AR 72032-4658 | 2015-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| Find all providers in zip 72032 | ||||
| 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 |
|---|---|---|---|---|
| 1134158231 | Horry County Comm On Alcohol & Drug Abuse | Substance Abuse Rehabilitation Facility | 2404 Wise Rd, Conway, SC 29526-5521 | 2006-07-01 |
| 1508310426 | Shoreline Behavioral Health Services | Substance Abuse Rehabilitation Facility | 2404 Wise Rd, Conway, SC 29526-5521 | 2016-08-09 |
| 1912350901 | Shoreline | Substance Abuse Rehabilitation Facility | 2404 Wise Rd, Conway, SC 29526 | 2016-07-14 |
| 1689019796 | Shoreline Behavioral Health Services | Substance Abuse Rehabilitation Facility | 2404 Wise Rd, Conway, SC 29526-5521 | 2013-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033737762 | Retreat At Skyridge | Substance Abuse Rehabilitation Facility | 637 County Road 111, Eureka Springs, AR 72631-9030 | 2020-07-09 |
| 1255971610 | Nsrc Oakgrove LLC | Substance Abuse Rehabilitation Facility | 10025 Oakland Dr, North Little Rock, AR 72118-1942 | 2020-01-13 |
| 1295385359 | Atlas Healthcare Associates, LLC | Substance Abuse Rehabilitation Facility | 408 Office Park Dr Ste 2, Bryant, AR 72022-7536 | 2019-09-19 |
| 1609429778 | Coatc LLC | Substance Abuse Rehabilitation Facility | 1807 E Lawson Rd, Little Rock, AR 72210-5012 | 2019-07-18 |
| 1730640558 | Teen Challenge Women's Ministries | Substance Abuse Rehabilitation Facility | 618 S Knoxville Ave, Russellville, AR 72801-6419 | 2019-03-26 |
| 1780114611 | Applegate Health Services, Inc | Substance Abuse Rehabilitation Facility | 403 W Oak St Ste 105, El Dorado, AR 71730-4573 | 2017-06-13 |
| 1518494863 | Cscb Rehabilitation Management Group, LLC | Substance Abuse Rehabilitation Facility | 1 Lile Court, Suite 103, Little Rock, AR 77005 | 2017-05-17 |
| 1013468925 | Preferred Family Health Care, Inc | Substance Abuse Rehabilitation Facility | 9219 Sibley Hall Road, Little Rock, AR 72209-0000 | 2016-10-17 |
| 1174907463 | Southwest Arkansas Counseling & Mental Health Center, Inc | Substance Abuse Rehabilitation Facility | 7000 N Stateline, Texarkana, AR 71854-2536 | 2015-07-16 |
| 1851770564 | Better Community Development, Inc | Substance Abuse Rehabilitation Facility | 3604 W 12th St, Little Rock, AR 72204-2139 | 2015-05-27 |
| 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.