NPI 1417053893

Phoenix Residence, INC.

Organisation Intellectual Disabilities Intermediate Care Facility Saint Paul, MN

Practice location

Address: 1538 Point Douglas Rd S, Saint Paul, MN 55119-6006
Phone: (651) 739-6930
Fax: (651) 739-1055
Mailing address: 330 Marie Ave E, West St Paul, MN 55118-4011

Authorised official

Name: Darlene M Scott
Title: President/Ceo
Phone: (651) 227-7655

Registered specialties

Intellectual Disabilities Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 315P00000X Licence 1032512 1RS (MN)

Other Intermediate Care Facility, Intellectual Disabilities providers in Minnesota →

Registry record

NPI: 1417053893
Entity type: Organization
NPI issued: 15 Sep 2006
Record last updated: 1 Jul 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.