PHOENIX HOUSES OF NE INC (NPI# 1992884787) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992884787 |
| Entity Type | Organization |
| Organization Name | PHOENIX HOUSES OF NE INC |
| Practice Address |
99 Wayland Ave Suite 100 Providence RI 02906-4314 |
| Practice Telephone | 4013314250 |
| Practice Fax Number | 4014215520 |
| Mailing Telephone | 4013314250 |
| Mailing Fax Number | 4014215520 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2012-03-21 |
| Authorized Official Name | MS. SUSAN SHUBITOWSKI (VP DIRECTOR OF FINANCE) |
| Authorized Official Telephone | 4013314250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | 621 | RI | Residential Treatment Facilities |
| N | 324500000X | Substance Abuse Rehabilitation Facility | 02725 | NH | Residential Treatment Facilities |
| N | 324500000X | Substance Abuse Rehabilitation Facility | 425678 | ME | Residential Treatment Facilities |
| N | 324500000X | Substance Abuse Rehabilitation Facility | 0296 | MA | Residential Treatment Facilities |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | CMC 00028 | RI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1009585 | 05 | |
| ME | MAINECARE | 15601000 | 01 |
| BC RI | 410878 | 01 | |
| RI | NHP RI | 9192 | 01 |
| BC RI | 30766 | 01 | |
| BC RI | 410875 | 01 | |
| VT | 1002232 | 05 | |
| VT | 1009358 | 05 | |
| NH | 30007117 | 05 | |
| RI | MA04867 | 05 | |
| ME | MAINECARE | 15601001 | 01 |
| BC RI | 30763 | 01 | |
| MOHEGAN SUN VALUE OPTIONS | 467656 | 01 | |
| RI | NHP RI | 9202 | 01 |
| BC RI | 6988 | 01 | |
| VT | 1006554 | 05 | |
| RI | NHP RI | 9515 | 01 |
| BC RI | 203388 | 01 | |
| RI | NHP RI | 9203 | 01 |
| Street Address |
99 WAYLAND AVE SUITE 100 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-4314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447538004 | Marcio Guzman | Counselor | 99 Wayland Ave, Providence, RI 02906-4314 | 2011-08-01 |
| 1972832293 | Amanda G. Taylor | Counselor | 99 Wayland Ave, Providence, RI 02906-4314 | 2009-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| 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 |
|---|---|---|---|---|
| 1639649684 | Sterling Recovery | Substance Abuse Rehabilitation Facility | 525 W 465 N Ste 130, Providence, UT 84332-5604 | 2018-12-03 |
| 1205387966 | Second Chnaces, Inc. | Substance Abuse Rehabilitation Facility | 381 Wickenden St, Providence, RI 02903-4425 | 2016-10-18 |
| 1477951176 | Map Behavioral Health Services, Inc | Substance Abuse Rehabilitation Facility | 66 Burnett St, Providence, RI 02907-2527 | 2014-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639799539 | Rogers Home Inc | Substance Abuse Rehabilitation Facility | 105 Beechwood Ave, Pawtucket, RI 02860-5409 | 2020-04-21 |
| 1003045782 | Galilee Mission | Substance Abuse Rehabilitation Facility | 268 Kingstown Rd, Narragansett, RI 02882-3237 | 2009-07-02 |
| 1871004754 | Palo Recovery Counseling | Substance Abuse Rehabilitation Facility | 55 Opper Ave, Warwick, RI 02889-2744 | 2017-10-18 |
| 1164822474 | Adcare Rhode Island | Substance Abuse Rehabilitation Facility | 1950 Tower Hill Rd, North Kingstown, RI 02852-6639 | 2014-08-25 |
| 1093848327 | Sstar of Rhode Island, Inc. | Substance Abuse Rehabilitation Facility | 1950 Tower Hill Rd, North Kingstown, RI 02852-6628 | 2007-03-14 |
| 1841323094 | Sstar of Rhode Island, Inc. | Substance Abuse Rehabilitation Facility | 80 East St, Cranston, RI 02920-4421 | 2007-03-14 |
| City | PROVIDENCE |
| Zip Code | 02906 |
Please comment or provide details below to improve the information on PHOENIX HOUSES OF NE 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.