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PHOENIX HOME #1

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ZULU NWANKWO (ADMINISTRATOR)
(919) 771-4517
Entity
Organization

Contact information

Practice address
2726 NEWSOME ST, RALEIGH, NC 27603-2956
(919) 771-4517
(919) 325-0671
Mailing address
2726 NEWSOME ST, RALEIGH, NC 27603-2956
(919) 771-4517
(919) 325-0671

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
092734

Other

Enumeration date
01/27/2009
Last updated
01/27/2009
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