Organization
PHOENIX SUPPORTED LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY J SCHMIDT (CEO)
(828) 389-1795
Entity
Organization
Contact information
Practice address
2996 NC 69 S, SUITE #6, HAYESVILLE, NC 28904
(828) 389-1795
Mailing address
2996 NC 69 S, SUITE #6, HAYESVILLE, NC 28904
(828) 389-1795
(828) 389-1658
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3409428
—
NC
05
—
7804263
—
NC
05
—
7804651
—
NC
05
—
7804847
—
NC
05
—
7805099
—
NC
05
—
7805326
—
NC
05
—
7805529
—
NC
05
—
8300648
—
NC
05
—
8300925
—
NC
05
—
8300926
—
NC
05
—
8300927
—
NC
05
—
8300971
—
NC
05
—
8301106
—
NC
05
—
8600541
—
NC
Enumeration date
11/03/2006
Last updated
08/22/2020
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