Organization
PHOENIX CHOICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIE ROUSH (CHIEF OPERATING OFFICER)
(865) 414-5059
Entity
Organization
Contact information
Practice address
616 SALISBURY LN, KNOXVILLE, TN 37934-5096
(865) 414-5059
Mailing address
616 SALISBURY LN, KNOXVILLE, TN 37934-5096
(865) 414-5059
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000000000
—
TN
Enumeration date
02/20/2020
Last updated
02/20/2020
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