Organization
PHOENIX RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONDA S CHAMBERS (CHIEF EXECUTIVE OFFICER)
(704) 254-4145
Entity
Organization
Contact information
Practice address
5003 HWY 74 EAST, WINGATE, NC 28174
(704) 327-4444
Mailing address
6605 E MARSHVILLE BLVD, MARSHVILLE, NC 28103-1199
(704) 327-4444
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/19/2024
Last updated
12/19/2024
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