Organization
PHOENIX DOMUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY ALAN MCCONNELL B.S., M.ED., CHES (PROGRAM MANAGER)
(814) 934-6513
Entity
Organization
Contact information
Practice address
114 BEECH AVE, ALTOONA, PA 16601-4235
(814) 502-5157
Mailing address
114 BEECH AVE, ALTOONA, PA 16601-4235
(814) 502-5157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077037
—
PA
Enumeration date
04/05/2021
Last updated
04/06/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us