Organization
PHOENIX CARE SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMIE SONTRELL ROBERSON (ADMINISTRATOR)
(910) 286-9197
Entity
Organization
Contact information
Practice address
105B PRESTON AVE, FAYETTEVILLE, NC 28301-3455
(910) 709-0167
Mailing address
910 HOPE MILLS RD, FAYETTEVILLE, NC 28304-4243
(910) 709-0167
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210608
—
NC
Enumeration date
08/17/2021
Last updated
10/05/2021
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