Provider Demographics
NPI:1528759685
Name:PHOENIX GRAFFITI LLC
Entity type:Organization
Organization Name:PHOENIX GRAFFITI LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:FOLSOM
Authorized Official - Last Name:DOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN, CSSD
Authorized Official - Phone:828-773-1829
Mailing Address - Street 1:7220 CANTERWAY DR
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-5104
Mailing Address - Country:US
Mailing Address - Phone:828-773-1829
Mailing Address - Fax:
Practice Address - Street 1:7220 CANTERWAY DR
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-5104
Practice Address - Country:US
Practice Address - Phone:828-773-1829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty