Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Phoenix Residence Inc

Organization Intellectual Disabilities Intermediate Care Facility · NPI 1245324920

Phoenix Residence Inc is an Intellectual Disabilities Intermediate Care Facility in Maplewood, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1866 Furness St
Maplewood, MN 55109
Phone: (651) 777-6349
Fax: (651) 779-9492
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual Disabilities Intermediate Care Facility (primary) Taxonomy 315P00000X · Licence 800870 (MN)

Record details

NPI number1245324920
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Darlene Scott — President Ceo · (651) 227-7655
NPI enumeratedOctober 3, 2006
Last updated in NPPESJuly 2, 2008
Mailing address330 Marie Avenue E, West St Paul, MN 55118-4011

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