| NPI | 1265891006 |
|---|---|
| Other Name | PHOENIX PROGRAM |
| Entity Type | Organization |
| Authorized Contact | DAVID NICHOLAS Director Of Revenue Cycle 703-825-8762 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: VA 122-01-033) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2022-04-20 |