Organization
PHOENIX NEST HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA ANIOCE-ANDRE LMHC (CLINICAL DIRECTOR)
(813) 843-4645
Entity
Organization
Contact information
Practice address
10203 COUNT FLEET DR, RUSKIN, FL 33573-6774
(813) 843-4645
(813) 448-1237
Mailing address
10203 COUNT FLEET DR, RUSKIN, FL 33573-6774
(813) 843-4645
(813) 448-1237
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251V00000X
Voluntary or Charitable Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/01/2026
Last updated
04/01/2026
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