Organization
PHOENIX BRIDGE GROUP HOMES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS WENDY RENEE JONES (PROGRAM MANAGER)
(336) 222-8522
Entity
Organization
Contact information
Practice address
3309 N NC HIGHWAY 49 # A, BURLINGTON, NC 27217-8589
(336) 578-0540
(336) 222-8533
Mailing address
120 S MAIN ST, GRAHAM, NC 27253-2808
(336) 222-8522
(336) 222-8533
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL -001 - 135
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL 001-100
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL 001-120
NC
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
MHL 001-121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603321
—
NC
05
—
6603357
—
NC
05
—
6603578
—
NC
05
—
6603972
—
NC
05
—
8301363
—
NC
Enumeration date
02/13/2007
Last updated
09/11/2025
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