PHOENIX RESIDENTIAL SERVICES; NPI #1558461657

Contact Information

PHOENIX RESIDENTIAL SERVICES

20 W 2ND ST
SUITE 200
SAND SPRINGS, OK 74063-7633

Phone: 918-245-1884
Fax: 918-245-0749
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Respite Care, Intellectual and/or Developmental Disabilities	385HR2060X
Home Health	251E00000X	A4[11]	Home Health Agency

Indicates primary specialty

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NPI Profile & details for PHOENIX RESIDENTIAL SERVICES

NPI Number 1558461657

LBN Legal business name PHOENIX RESIDENTIAL SERVICES

Authorized official LISA TOTH - (CEO/OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 09/25/2006

Last updated 06/01/2012 - About 14 years ago

Identifiers

OK	License #	200045930
OK	License #	7960
OK	Medicaid	200045930 A
OK	Medicaid	200045930 B
OK	Medicaid	200045930 C
OK	Medicaid	200045930 D
OK	Medicaid	200045930 E
OK	Medicaid	200045930 F
OK	Medicaid	200045930 G

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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