Phoenix Residence, Inc
Phoenix Residence, Inc is an Intellectual Disabilities Intermediate Care Facility in White Bear Lake, 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.
Practice location Address checks out
2168 12th StWhite Bear Lake, MN 55110
Phone: (651) 653-3713
Fax: (651) 653-5784
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual Disabilities Intermediate Care Facility (primary) | Taxonomy 315P00000X · Licence 1032511 1 RS (MN) |
|---|
Record details
| NPI number | 1457458812 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Darlene Scott — President/Ceo · (651) 227-7655 |
| NPI enumerated | September 20, 2006 |
| Last updated in NPPES | July 1, 2008 |
| Mailing address | 330 Marie Ave E, West St Paul, MN 55118-4011 |
Other providers in White Bear Lake
-
Axis Minnesota, Inc
3516 White Bear Ave N, White Bear Lake, MN 55110-5419 · (651) 774-5940