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Organization
PHOENIX INDEPENDENT LIVING INC
Active
Organization
PHOENIX INDEPENDENT LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN HOLCOMB HOLCOMB (ADMINISTRATION)
(601) 325-8121
Entity
Organization
Contact information
Practice address
2810 53RD AVE APT B, GULFPORT, MS 39501-5644
(601) 596-3786
Mailing address
2810 53RD AVE APT B, GULFPORT, MS 39501-5644
(601) 596-3786
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
01/17/2026
Last updated
01/17/2026
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