Organization
PHOENIX GROUP HOME, LLC
Active
Parent organization
PHOENIX GROUP HOME LLC
Other names
Path Integrated Health, Path Behavioral Healthcare, Path Behavioral Health- SUD
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX GROUP HOME LLC
Authorized official
ABBIE CARPENTER (CREDENTIALING SPECIALIST)
(304) 794-6285
Entity
Organization
Contact information
Practice address
3012 GLENMORE AVE STE 104, CINCINNATI, OH 45238-2258
(740) 858-1659
(740) 876-9213
Mailing address
257 E 200 S STE 350, SALT LAKE CITY, UT 84111-2085
(740) 858-1659
(740) 876-9213
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
12/06/2017
Last updated
08/17/2026
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