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Organization

PHOENIX SUPPORT SERVICES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILIP FUHRER (CFO)
(732) 239-3414
Entity
Organization

Contact information

Practice address
1014 WHITEHEAD ROAD EXT, EWING, NJ 08638-2406
(732) 239-3414
Mailing address
1014 WHITEHEAD ROAD EXT, EWING, NJ 08638-2406
(732) 239-3414

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
04/18/2019
Last updated
04/18/2019
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