Healthcare Provider Details

I. General information

NPI: 1881530913
Provider Name (Legal Business Name): PHOENIX OASIS RECOVERY HOMES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5125 W MYRTLE AVE
GLENDALE AZ
85301-2007
US

IV. Provider business mailing address

2218 E POLK ST
PHOENIX AZ
85006-3986
US

V. Phone/Fax

Practice location:
  • Phone: 602-686-7260
  • Fax:
Mailing address:
  • Phone: 602-686-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY J PFEFFER
Title or Position: CEO
Credential:
Phone: 602-686-7260