Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Phoenix Outdoor

Organization Emotionally Disturbed Childrens' Residential Treatment Facility · NPI 1750522058

Phoenix Outdoor is an Emotionally Disturbed Childrens' Residential Treatment Facility in Leicester, North Carolina. Licensed in North Carolina. Registered with an NPI since 2009.

Licensed in
NC
In the registry since
2009
Specialties on file
2

Practice location Address checks out

631 Willow Creek Rd
Leicester, NC 28748-5646
Phone: (828) 683-7718
Fax: (828) 683-9995
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Children's Substance Abuse Rehabilitation Facility (primary) Taxonomy 3245S0500X · Licence MHL-011-279 (NC)
Emotionally Disturbed Childrens' Residential Treatment Facility Taxonomy 322D00000X · Licence MHL-011-279 (NC)

Record details

NPI number1750522058
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karen Nilsen — Office Assistant · (828) 668-7590
NPI enumeratedMarch 16, 2009
Last updated in NPPESMarch 16, 2009
Mailing address631 Willow Creek Rd, Leicester, NC 28748-5646