Organization
PHOENIX HOME FOR BOYS
Active
Parent organization
PHOENIX GROUP HOMES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX GROUP HOMES, INC.
Authorized official
MRS. RONDA MITCHELL BYTHEWOOD (EXECUTIVE DIRECTOR)
(828) 439-9911
Entity
Organization
Contact information
Practice address
117 WILLIAM PARKS LN, MORGANTON, NC 28655-9173
(828) 584-1589
(828) 584-1589
Mailing address
PO BOX 2386, MORGANTON, NC 28680-2386
(828) 439-9911
(828) 439-9911
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-012-009
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603042
—
NC
Enumeration date
08/05/2007
Last updated
08/06/2007
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