Phoenix Residence, Inc. in Saint Paul - Intermediate Care Facility, Intellectual Disabilities
Phoenix Residence, Inc. - NPI 1417053893
Phoenix Residence, Inc. is a Intermediate Care Facility, Intellectual Disabilities in Saint Paul, 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 1417053893. The last update date is 2008-07-01.
Phoenix Residence, Inc.'s current location address is 1538 Point Douglas Rd S, Saint Paul, Minnesota. You can contact this provider via phone number 6517396930 and fax number 6517391055. The mailing address for Phoenix Residence, Inc. is 1538 Point Douglas Rd S, Saint Paul, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Phoenix Residence, Inc. |
|---|---|
| Address | 1538 Point Douglas Rd S, Saint Paul, Minnesota |
| Phone Number | 6517396930 |
| Fax Number | 6517391055 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT/ |
|---|---|
| Authorized Official Name | Scott M Darlene |
| Telephone Number | 6512277655 |
NPI Number Detail
| NPI Number | 1417053893 |
|---|---|
| Provider Enumeration Date | 2006-09-15 |
| Last Updated Date | 2008-07-01 |
Provider Mailing Address Detail
| Address | 1538 Point Douglas Rd S |
|---|---|
| City | Saint Paul |
| State | Minnesota (MN) |
| Post Code | 551196006 |
| Phone Number | 6517396930 |
| Fax Number | 6517391055 |
Provider's Primary Taxonomy Detail
| Speciality | Intermediate Care Facility, Intellectual Disabilities |
|---|---|
| Taxonomy | 315P00000X |
| Licence No | 1032512 1RS |
|
Definition: An intermediate care facility providing services for individuals with intellectual disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 849607200 | MN | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Phoenix Residence, Inc. by the Centers for Medicare & Medicaid Services?
The Phoenix Residence, Inc. has been issued the NPI (National Provider Identifier) 1417053893 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please share the complete physical location address where Phoenix Residence, Inc.'s facilities are situated?
The facilities of Phoenix Residence, Inc. are physically located at the following address: 1538 Point Douglas Rd S, Saint Paul, MN, 551196006.
What is Phoenix Residence, Inc.'s primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Phoenix Residence, Inc. is Intermediate Care Facility, Intellectual Disabilities, and the corresponding taxonomy classification code for this specialized field is 315P00000X.
When was the Phoenix Residence, Inc.'s 1417053893 issued?
The Phoenix Residence, Inc.'s 1417053893 was issued on 2006-09-15.
As of what date were the details related to Phoenix Residence, Inc. most recently updated or revised?
The information pertaining to Phoenix Residence, Inc., including its address, specialty, and other relevant details, was last updated or revised on 2008-07-01.