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PHOENIX RESIDENCE, INC.
NPI 1134217037
Intermediate Care Facility, Intellectual Disabilities in Maplewood, MN

Active since October 10, 2006
1685 HOWARD ST, MAPLEWOOD, MN 55109(651) 777-6754(651) 779-9339 Get Directions Write a Review

NPPES record last updated: July 1, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Phoenix Residence, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHOENIX RESIDENCE, INC. (NPI 1134217037) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Maplewood, Minnesota and active in the NPI registry since October 2006. The organization lists Darlene M Scott, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1134217037
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NamePHOENIX RESIDENCE, INC.
Location Address1685 HOWARD STMaplewood, MN 55109
Mailing Address330 Marie Ave EWest St Paul, MN 55118-4011 · (651) 227-7655 · Fax (651) 227-6847
Phone(651) 777-6754
Fax(651) 779-9339
Organization SubpartNo
Authorized OfficialDarlene M ScottPresident/ceo · (651) 227-7655
Enumeration DateOctober 10, 2006
Last NPPES UpdateJuly 1, 2008
✔ NPI 1134217037 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License✔ Licensed in MN · 801102
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1685 HOWARD ST, Maplewood, MN 55109
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Other Identifiers 1

Medicaid273545800MN

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phoenix Residence, Inc.'s NPI number?

The NPI number for Phoenix Residence, Inc. is 1134217037. It was assigned to this organization in the NPPES registry on October 10, 2006.

Where is Phoenix Residence, Inc. located?

Phoenix Residence, Inc. is located at 1685 Howard St, Maplewood, MN 55109. The listed phone number is (651) 777-6754.

What is Phoenix Residence, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Phoenix Residence, Inc. was last updated on July 1, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.