Healthcare Provider Details

I. General information

NPI: 1336261361
Provider Name (Legal Business Name): PHOENIX SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W PENN AVE
CLEONA PA
17042-3230
US

IV. Provider business mailing address

1655 VALLEY CENTER PKWY SUITE 150
BETHLEHEM PA
18017-2293
US

V. Phone/Fax

Practice location:
  • Phone: 717-228-0400
  • Fax: 717-228-3929
Mailing address:
  • Phone: 484-893-5050
  • Fax: 484-893-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number305510
License Number StatePA

VIII. Authorized Official

Name: MR. DEVIN P. MCFERREN
Title or Position: PRESIDENT AND CEO
Credential: M.ED.
Phone: 717-228-0400