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Organization
PHOENIX HOUSE FOUNDATION, INC.
Active
Organization
PHOENIX HOUSE FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN KIRCHOFF (SR. VICE PRESIDENT, CFO)
(212) 595-5810
Entity
Organization
Contact information
Practice address
164 W 74TH ST, NEW YORK, NY 10023-2301
(718) 222-6600
(718) 576-2866
Mailing address
50 JAY ST, 3RS FL, BROOKLYN, NY 11201-1144
(718) 222-6600
(718) 576-2866
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
7002298R
NY
Other
Enumeration date
11/30/2006
Last updated
08/22/2020
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