OrganizationActive
Phoenix House Child Agency
NPI 1053586065 · Custodial Care Facility · Waxhaw, NC
Provider details
- NPI number
- 1053586065
- Entity type
- Organization
- Primary specialty
- Custodial Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Leslie Taylor, Social Worker(704) 536-7931
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
8916 Woodhall Lake Dr
Waxhaw, NC 28173-6800
Phone: (704) 536-7931
Approximate (ZIP-level) locationGet directions
Mailing address
8916 Woodhall Lake Dr
Waxhaw, NC 28173-6800
Registry dates
- Enumerated
- 2008-04-30
- Last updated
- 2008-04-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.