Provider Demographics
NPI:1932099959
Name:PHASE9, LLC
Entity type:Organization
Organization Name:PHASE9, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLIGEN
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, BFM, MS,IT
Authorized Official - Phone:980-260-9375
Mailing Address - Street 1:57 UNION ST S
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-5264
Mailing Address - Country:US
Mailing Address - Phone:800-571-6027
Mailing Address - Fax:
Practice Address - Street 1:57 UNION ST S
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5264
Practice Address - Country:US
Practice Address - Phone:800-571-6027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care