Phoenix Residence, Inc. in Maplewood - Intermediate Care Facility, Intellectual Disabilities
Phoenix Residence, Inc. - NPI 1134217037
Phoenix Residence, Inc. is a Intermediate Care Facility, Intellectual Disabilities in Maplewood, Minnesota. Phoenix Residence, Inc. practices all healthcare services and medical treatments related to Intermediate Care Facility, Intellectual Disabilities. The NPI Number for Phoenix Residence, Inc. is 1134217037. The last update date is 2008-07-01.
Phoenix Residence, Inc.'s current location address is 1685 Howard St, Maplewood, Minnesota. You can contact this provider via phone number 6517776754 and fax number 6517799339. The mailing address for Phoenix Residence, Inc. is 1685 Howard St, Maplewood, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Phoenix Residence, Inc. |
|---|---|
| Address | 1685 Howard St, Maplewood, Minnesota |
| Phone Number | 6517776754 |
| Fax Number | 6517799339 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT/ |
|---|---|
| Authorized Official Name | Scott M Darlene |
| Telephone Number | 6512277655 |
NPI Number Detail
| NPI Number | 1134217037 |
|---|---|
| Provider Enumeration Date | 2006-10-10 |
| Last Updated Date | 2008-07-01 |
Provider Mailing Address Detail
| Address | 1685 Howard St |
|---|---|
| City | Maplewood |
| State | Minnesota (MN) |
| Post Code | 55109 |
| Phone Number | 6517776754 |
| Fax Number | 6517799339 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 801102 |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 273545800 | MN | -- |
Post Comment/ Review Below
What is the Phoenix Residence, Inc.'s unique identification number?
The Phoenix Residence, Inc. has been assigned the NPI (National Provider Identifier) Number 1134217037 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Phoenix Residence, Inc.?
The Phoenix Residence, Inc. is situated at 1685 Howard St, in the city of Maplewood, state of MN, with the zip code 55109.
What is the area of specialization for Phoenix Residence, Inc., and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Phoenix Residence, Inc. is Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy code that categorizes this area of expertise is 315P00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1134217037 to Phoenix Residence, Inc.?
The Centers for Medicare & Medicaid Services originally issued the 1134217037 to Phoenix Residence, Inc. on 2006-10-10.
As of what date were the details pertaining to Phoenix Residence, Inc. last refreshed?
The information related to the Phoenix Residence, Inc., including its address, specialty, and other relevant details, was last updated on 2008-07-01.