Organization
PHOENIX HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE MAAG MS., LPC, LSW (CEO)
(419) 692-2421
Entity
Organization
Contact information
Practice address
233 N MAIN ST, DELPHOS, OH 45891
(419) 692-2421
(419) 692-2300
Mailing address
233 N MAIN ST, DELPHOS, OH 45891
(419) 692-2421
(419) 692-2300
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
00294
MD
251S00000X
Community/Behavioral Health Agency
40064
RI
251S00000X
Community/Behavioral Health Agency
Primary
496
OH
251S00000X
Community/Behavioral Health Agency
500544
KY
251S00000X
Community/Behavioral Health Agency
SO10102A
TN
251S00000X
Community/Behavioral Health Agency
SO10103A
TN
251S00000X
Community/Behavioral Health Agency
SO10124A
TN
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
046478
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322D0000X
—
AL
Enumeration date
05/03/2007
Last updated
07/22/2008
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