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General NPI Number Information
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NPI Number | 1255872073
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Entity Type | Organization
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Legal Business Name | PHOENIX FAMILY AND COMMUNITY SERVICES, LLC
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 03/13/2017
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Provider Practice Location Address
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Address Line | 2346 S. LYNHURST DR. SUITE 601
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City | INDIANAPOLIS
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State | IN
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Zip | 46241
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Country | US
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Telephone | 317-389-5374
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Fax |
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Provider Business Mailing Address
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Address Line | 6203 TIMBERLAND CT
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City | INDIANAPOLIS
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State | IN
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Zip | 46221
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Country | US
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Telephone | 317-756-8954
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Fax | 317-991-5651
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Authorized Official
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Title or Position | OWNER
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Name | MR. CAROL AKINS FRANKLIN
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Credential |
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Telephone | 317-756-8954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | IN
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