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Phoenix Outdoor
Children's Substance Abuse Rehabilitation Facility in Leicester, North Carolina
NPI 1750522058

Phoenix Outdoor is a Children's Substance Abuse Rehabilitation Facility based in Leicester, NC and is specialized in Substance Abuse Treatment, Children. Phoenix Outdoor practices in Leicester, NC. The NPI Number for Phoenix Outdoor is 1750522058 and holds a License No. MHL-011-279 (North Carolina).

The current practice location address for Phoenix Outdoor is 631 Willow Creek Rd, Leicester, NC and can be reached out via phone at 828-683-7718 and via fax at 828-683-9995.

Location: 631 Willow Creek Rd, Leicester, NC, 28748-5646
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1750522058
Provider Name
Phoenix Outdoor
Credential
Provider Entity Type
Organization
Address
631 Willow Creek Rd, Leicester, NC, 28748-5646
Phone Number
828-683-7718
Fax Number
828-683-9995
Provider Enumeration Date
03/16/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
631 Willow Creek Rd
City
Leicester
State
North Carolina
Zip
28748-5646
Phone Number
828-683-7718
Fax Number
828-683-9995
person
Provider Business Mailing Address Details
Address
631 Willow Creek Rd
City
Leicester
State
North Carolina
Zip
28748-5646
Phone Number
828-683-7718
Fax Number
828-683-9995
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
MHL-011-279 (North Carolina)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
Substance Abuse Treatment, Children
Taxonomy
3245S0500X
License No.
MHL-011-279 (North Carolina)
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.
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