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PHOENIX RESIDENCE INC
NPI 1245324920
Intermediate Care Facility, Intellectual Disabilities in Maplewood, MN

Active since October 03, 2006
1866 FURNESS STREET, MAPLEWOOD, MN 55109(651) 777-6349(651) 779-9492 Get Directions Write a Review

NPPES record last updated: July 2, 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 1245324920) 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

NPI1245324920
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NamePHOENIX RESIDENCE INC
Location Address1866 FURNESS STREETMaplewood, MN 55109
Mailing Address330 Marie Avenue EWest St Paul, MN 55118-4011 · (651) 227-7655 · Fax (651) 227-6847
Phone(651) 777-6349
Fax(651) 779-9492
Organization SubpartNo
Authorized OfficialDarlene M ScottPresident Ceo · (651) 227-7655
Enumeration DateOctober 3, 2006
Last NPPES UpdateJuly 2, 2008
✔ NPI 1245324920 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 · 800870
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
1866 FURNESS STREET, Maplewood, MN 55109
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Other Identifiers 1

Medicaid443545100MN

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 1245324920. It was assigned to this organization in the NPPES registry on October 3, 2006.

Where is Phoenix Residence Inc located?

Phoenix Residence Inc is located at 1866 Furness Street, Maplewood, MN 55109. The listed phone number is (651) 777-6349.

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 2, 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.