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Organization

PHOENIX RESIDENTIAL INVESTMENT GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DETITRIA MUTIZWA (PROGRAM ADMINISTRATOR)
(214) 301-8900
Entity
Organization

Contact information

Practice address
127 WILSON RD, WAXAHACHIE, TX 75165-9185
(214) 301-8900
Mailing address
608 CHAPEL PL, CEDAR HILL, TX 75104-1760
(214) 301-8900

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
106S00000X
Behavior Technician
171M00000X
Case Manager/Care Coordinator
175T00000X
Peer Specialist
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
Primary
253J00000X
Foster Care Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
323P00000X
Psychiatric Residential Treatment Facility

Other

Enumeration date
12/21/2022
Last updated
03/20/2026
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