Organization
PHOENIX SUPPORTED LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET MELISSA NEMKOVICH (DIRECTOR)
(828) 389-1795
Entity
Organization
Contact information
Practice address
284 SMOKEFORD ROAD, MURPHY, NC 28906
(828) 389-1795
(828) 389-1658
Mailing address
2996 NC 69, SUITE 6, HAYESVILLE, NC 28904-7257
(828) 389-1795
(828) 389-1658
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
7804263
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804263
—
NC
Enumeration date
01/26/2007
Last updated
08/22/2020
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