Provider Demographics
NPI:1700327889
Name:PHOENIX FAMILY WELLNESS, LLC
Entity Type:Organization
Organization Name:PHOENIX FAMILY WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-389-5374
Mailing Address - Street 1:6203 TIMBERLAND CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46221-4554
Mailing Address - Country:US
Mailing Address - Phone:317-389-5374
Mailing Address - Fax:317-991-5651
Practice Address - Street 1:2345 S LYNHURST DR
Practice Address - Street 2:SUITE 218
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-8630
Practice Address - Country:US
Practice Address - Phone:317-389-5374
Practice Address - Fax:317-991-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care