# PHOENIX HOME FOR BOYS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PHOENIX GROUP HOMES, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588855787
- **Legal business name:** PHOENIX GROUP HOMES, INC.
- **Authorized official:** MRS. RONDA MITCHELL BYTHEWOOD (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (828) 439-9911

## Contact information

- **Practice address:** 117 WILLIAM PARKS LN, MORGANTON, NC 28655-9173
- **Practice address phone:** (828) 584-1589
- **Practice address fax:** (828) 584-1589
- **Mailing address:** PO BOX 2386, MORGANTON, NC 28680-2386
- **Mailing address phone:** (828) 439-9911
- **Mailing address fax:** (828) 439-9911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | MHL-012-009 | NC | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 08/06/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6603042 | — | NC |