Organization
PHOENIX HOUSE CHILD AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LESLIE TAYLOR (SOCIAL WORKER)
(704) 536-7931
Entity
Organization
Contact information
Practice address
8916 WOODHALL LAKE DR, WAXHAW, NC 28173-6800
(704) 536-7931
Mailing address
8916 WOODHALL LAKE DR, WAXHAW, NC 28173-6800
(704) 536-7931
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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