Organization · Type 2 NPI
Phoenix Independent Living Inc
Adult Care Home Facility · Gulfport, MS
NPI number
1124825666
Active
Practice location
2810 53rd Ave # B
Gulfport, MS 39501-5644
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Laboratory Technician | 246RM2200X | None listed |
| Adult Care Home Facility Primary | 311ZA0620X | None listed |
| Non-emergency Medical Transport (VAN) | 343900000X | None listed |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
About NPI 1124825666
Phoenix Independent Living Inc's National Provider Identifier is 1124825666, issued on Mar 3, 2025. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Gulfport, MS. The record was last updated on Mar 3, 2025.