Provider Demographics
NPI:1447016951
Name:PHOCCUS HEALTH COMPANY
Entity type:Organization
Organization Name:PHOCCUS HEALTH COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESIRE'E
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS-NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-898-6092
Mailing Address - Street 1:3353 MEADOWMONT LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-2148
Mailing Address - Country:US
Mailing Address - Phone:804-898-6092
Mailing Address - Fax:
Practice Address - Street 1:904 N 1ST ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1000
Practice Address - Country:US
Practice Address - Phone:804-601-6263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness