NPI 1023408309

Phoenix House

Organisation Substance Abuse Rehabilitation Facility Springfield, MA

Practice location

Address: 5 Madison Ave, Springfield, MA 01105-1403
Phone: (413) 733-6051
Mailing address: 5 Madison Avenue, Springfield, MA 01105

Authorised official

Name: Ellen M Waltman
Title: Clinical Supervisor
Phone: (413) 355-6832

Registered specialties (3)

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 745 (MA)

Other Substance Abuse Rehabilitation Facility providers in Massachusetts →

Community/Behavioral Health Agency

Agencies Taxonomy 251S00000X Licence 745 (MA)

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Exclusive Provider Organization

Managed Care Organizations Taxonomy 302F00000X Licence 745 (MA)

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Registry record

NPI: 1023408309
Entity type: Organization
NPI issued: 26 Jan 2015
Record last updated: 26 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.