Organization
PHOENIX TREATMENT CENTERS OUTPATIENT DIVISION, LLC
Active
Parent organization
PHOENIX TREATMENT CENTERS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX TREATMENT CENTERS, LLC
Authorized official
MRS. AMBER SISCO (OWNER)
(606) 367-3980
Entity
Organization
Contact information
Practice address
400 VENTERS LN STE 100, PIKEVILLE, KY 41501-3016
(606) 653-1505
Mailing address
PO BOX 1285, PIKEVILLE, KY 41502-1285
(606) 658-3078
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
09/05/2023
Last updated
03/23/2024
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