PHOENIX RECOVERY CENTER INC; NPI #1417006503

Contact Information

PHOENIX RECOVERY CENTER INC

107 EDGEWOOD RD
EDGEWOOD, MD 21040

Phone: 410-671-7374
Fax: 410-679-7757
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation, Substance Use Disorder	261QR0405X

Indicates primary specialty

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NPI Profile & details for PHOENIX RECOVERY CENTER INC

NPI # 1417006503

LBN Legal business name PHOENIX RECOVERY CENTER INC

Authorized official ROBERT KINNEBERG - (DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/09/2007

Last updated 06/10/2020 - About 6 years ago

Identifiers

License #

13137

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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