Organization
PHOENIX COMMUNITY SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASHUNDA SMITH POPE (OWNER)
(205) 346-3123
Entity
Organization
Contact information
Practice address
4111 AVENUE L, BIRMINGHAM, AL 35208-1807
(803) 849-2925
Mailing address
4111 AVENUE L, BIRMINGHAM, AL 35208-1807
(803) 849-2925
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Enumeration date
10/09/2020
Last updated
10/27/2020
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