OrganizationActive
Phoenix Outdoor
NPI 1750522058 · Children's Substance Abuse Rehabilitation Facility · Leicester, NC
Provider details
- NPI number
- 1750522058
- Entity type
- Organization
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Karen Nilsen, Office Assistant(828) 668-7590
- License
- MHL-011-279 (NC)
Specialties & taxonomies
Residential Treatment Facilities
Residential Treatment Facilities
Practice location
631 Willow Creek Rd
Leicester, NC 28748-5646
Phone: (828) 683-7718
Fax: (828) 683-9995
Approximate (ZIP-level) locationGet directions
Mailing address
631 Willow Creek Rd
Leicester, NC 28748-5646
Registry dates
- Enumerated
- 2009-03-16
- Last updated
- 2009-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.