Organization
PHOENIX HOUSE FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOYCE LORRAINE BERNABO RN (RN)
(718) 726-8484
Entity
Organization
Contact information
Practice address
3411 VERNON BLVD, LONG ISLAND CITY, NY 11106-5121
(718) 726-8484
Mailing address
9328 85TH RD, WOODHAVEN, NY 11421-1418
(718) 846-8187
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
414715-1
NY
Other
Enumeration date
12/07/2006
Last updated
08/22/2020
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