Healthcare Provider Details

I. General information

NPI: 1861739054
Provider Name (Legal Business Name): PHOENIX SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 01/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 S COMMERCE WAY
BETHLEHEM PA
18017-8934
US

IV. Provider business mailing address

83 S COMMERCE WAY
BETHLEHEM PA
18017-8934
US

V. Phone/Fax

Practice location:
  • Phone: 610-717-5722
  • Fax: 610-750-7167
Mailing address:
  • Phone: 610-717-5722
  • Fax: 610-750-7167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberCER-00051230
License Number StatePA

VIII. Authorized Official

Name: MS. JOYCE A GERBER
Title or Position: EXECUTIVE DIRECTOR
Credential: MS, RN, BC
Phone: 610-717-5722