Provider Demographics
NPI:1275399271
Name:PHOENIX RECOVERY LLC
Entity Type:Organization
Organization Name:PHOENIX RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWEINHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-536-1922
Mailing Address - Street 1:1037 GOODWIN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-3809
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1037 GOODWIN DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-3809
Practice Address - Country:US
Practice Address - Phone:859-536-1922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health