Organization
PHOENIX BRIDGE GROUP HOMES, INC.
Active
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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