Provider Demographics
NPI:1497404131
Name:PHENIX THERAPIES, LLC
Entity Type:Organization
Organization Name:PHENIX THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:SHENTELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-327-1318
Mailing Address - Street 1:3582 BLUE HORIZON VIEW SUITE 156
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924
Mailing Address - Country:US
Mailing Address - Phone:719-344-9497
Mailing Address - Fax:
Practice Address - Street 1:3582 BLUE HORIZON VIEW SUITE 156
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80924
Practice Address - Country:US
Practice Address - Phone:719-344-9497
Practice Address - Fax:719-358-6042
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHENIX THERAPIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty