# PHOENIX HOUSE FOUNDATION, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639247653
- **Authorized official:** MR. KEVIN KIRCHOFF (SR. VICE PRESIDENT, CFO)
- **Authorized official phone:** (212) 595-5810

## Contact information

- **Practice address:** 164 W 74TH ST, NEW YORK, NY 10023-2301
- **Practice address phone:** (718) 222-6600
- **Practice address fax:** (718) 576-2866
- **Mailing address:** 50 JAY ST, 3RS FL, BROOKLYN, NY 11201-1144
- **Mailing address phone:** (718) 222-6600
- **Mailing address fax:** (718) 576-2866

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 7002298R | NY | Yes |

## Other

- **Enumeration date:** 11/30/2006
- **Last updated:** 08/22/2020