| Ascending Phoenix Services | |
|
5349 Baxter Rd Disputanta VA 23842-3801 | |
| (757) 362-6691 | |
| Not Available |
| Full Name | Ascending Phoenix Services |
|---|---|
| Speciality | Counselor - Professional |
| Location | 5349 Baxter Rd, Disputanta, Virginia |
| Authorized Official Name and Position | Ozzie Richard Deloach (CFO/ CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7573626691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascending Phoenix Services 1601 Willow Lawn Drive Ste 304 Box # 1202 Richmond VA 23230 Ph: (757) 362-6691 | Ascending Phoenix Services 5349 Baxter Rd Disputanta VA 23842-3801 Ph: (757) 362-6691 |
| NPI Number | 1518876820 |
|---|---|
| Provider Enumeration Date | 09/02/2026 |
| Last Update Date | 09/02/2026 |
| Certification Date | 09/02/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518876820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Primary |
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