PHOENIX HOUSE CHILD AGENCY (NPI# 1053586065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053586065 |
| Entity Type | Organization |
| Organization Name | PHOENIX HOUSE CHILD AGENCY |
| Practice Address |
8916 Woodhall Lake Dr Waxhaw NC 28173-6800 |
| Practice Telephone | 7045367931 |
| Mailing Telephone | 7045367931 |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |
| Authorized Official Name | MISS LESLIE TAYLOR (SOCIAL WORKER) |
| Authorized Official Telephone | 7045367931 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities |
| Street Address |
8916 WOODHALL LAKE DR |
| City | WAXHAW |
| State | NC |
| Zip Code | 28173-6800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942394101 | Phoenix House, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 8916 Woodhall Lake Dr, Waxhaw, NC 28173-6800 | 2006-10-03 |
| 1699196535 | Ralph Taylor | Counselor | 8916 Woodhall Lake Dr, Waxhaw, NC 28173-6800 | 2013-12-19 |
| 1710308648 | Leslie Taylor | Social Worker | 8916 Woodhall Lake Dr, Waxhaw, NC 28173-6800 | 2013-12-19 |
| 1861529398 | Phoenix House Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8916 Woodhall Lake Dr, Waxhaw, NC 28173-6800 | 2007-02-28 |
| 1124164405 | Phoenix House, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 8916 Woodhall Lake Dr, Waxhaw, NC 28173-6800 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733175 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 1615 Providence Road South, Marvin, NC 28173 | 2020-06-04 |
| 1225507320 | Shane Markey Dds Ms Pllc | Dentist | 8412 New Town Rd Ste A, Waxhaw, NC 28173 | 2018-11-19 |
| 1336631514 | Suganya Nelatoor,d.d.s.,p.l.l.c. | Clinic/Center | 102 E Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2018-06-04 |
| 1184120750 | Restore Healthcare Medical Group | Counselor | 500 Waxhaw Professional Park Drive, Ste 105 F, Waxhaw, NC 28173 | 2018-04-03 |
| 1730690827 | Concrete Roses Consulting | Community/Behavioral Health | 5960 Fairview Road, 323, Charlotte, NC 28173 | 2017-10-17 |
| 1861849523 | Kayla Selena Caldwell | Social Worker | 3908 Rev. H. Morrison Rd., Waxhaw, NC 28173 | 2016-05-23 |
| 1588023782 | Teri Hipp | Counselor | 101-e Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2016-02-16 |
| 1710355508 | Caresmatic Phase 1,inc. | Assisted Living Facility | 520 Pembroke Ln., Waxhaw, NC 28173 | 2015-09-10 |
| 1437564838 | Anna Waddell Schneiderman | Counselor | 104 Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2014-06-24 |
| 1467892109 | Samantha Weidele Waldman | Counselor | 9929 Rea Rd Ste 201, Waxhaw, NC 28173 | 2013-06-26 |
| Find all providers in zip 28173 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669070215 | My Guardian Angel Family Care Home | Custodial Care Facility | 514 Cokey Road, Rocky Mount, NC 27801 | 2020-10-15 |
| 1932692159 | Carillon Assisted Living of Garner LLC | Custodial Care Facility | 200 Minglewood Dr, Garner, NC 27529-5273 | 2018-06-12 |
| 1821598335 | Sonya Waddell | Custodial Care Facility | 6025 Dustin Ridge Ct, Rural Hall, NC 27045-9011 | 2018-02-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1518331669 | Carillon Assisted Living of Huntersville, LLC | Custodial Care Facility | 250 Commerce Center Dr, Huntersville, NC 28078 | 2015-11-30 |
| 1871961631 | Wake Forest Adult Day Care Inc | Custodial Care Facility | 3309 Rogers Rd, Suite 117, Wake Forest, NC 27587-3943 | 2015-09-10 |
| 1407238355 | Guardian Care Advisors, Inc. | Custodial Care Facility | 1320 Ashley Sq, Winston Salem, NC 27103-2919 | 2015-06-26 |
| 1275922171 | Freedom Ministries Church and Outreach | Custodial Care Facility | 539 Railway Place, Concord, NC 28025-0000 | 2015-01-15 |
| 1962803551 | Carillon Assisted Living of Clemmons, LLC | Custodial Care Facility | 1165 S Peace Haven Rd, Clemmons, NC 27012-8910 | 2014-09-15 |
| 1487062311 | Douglas Family Care | Custodial Care Facility | 1439 Us Highway 13 S, Ahoskie, NC 27910-8125 | 2014-07-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.