Provider Demographics
NPI:1568728830
Name:PHYLCHRIS, INC.
Entity Type:Organization
Organization Name:PHYLCHRIS, INC.
Other - Org Name:MASSAC'S NURSING AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSAC
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSN
Authorized Official - Phone:340-774-9177
Mailing Address - Street 1:PO BOX 8980
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-1980
Mailing Address - Country:US
Mailing Address - Phone:340-774-9177
Mailing Address - Fax:
Practice Address - Street 1:4-4-14 ESTATE FORTUNA
Practice Address - Street 2:
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-774-9715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1-8208-3L251E00000X, 251G00000X, 313M00000X
VI1-8208-2L313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based