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Organization

HEART OF A PHOENIX ORGANIZATION LLC

Active
Other names
Heart of a Phoenix Organization LLC/PLLC, Refreshed Minds and Wellness LLC, Heart of a Phoenix Organization PLLC, Heart of a Phoenix Organization
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHAWNDELE LANIK DANZY NP (CEO/PRESIDENT)
(803) 518-9079
Entity
Organization

Contact information

Practice address
8180 REGENT PKWY STE 117, FORT MILL, SC 29715-8417
(803) 518-9079
(704) 626-6855
Mailing address
8180 REGENT PKWY STE 117, FORT MILL, SC 29715-8417
(704) 626-6855
(704) 520-8162

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00441136
NC
05
1467049015
MI
05
NP7553
SC
Enumeration date
04/01/2021
Last updated
11/21/2025
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