PHOENIX RESIDENCE, INC. – Intellectual Disabilities Intermediate Care Facility, NPI 1134217037

PHOENIX RESIDENCE, INC. is a healthcare provider. based in West st paul, Minnesota. specializing in Intellectual Disabilities Intermediate Care Facility. The organization holds a License No. 801102 (MN). The NPI Number for PHOENIX RESIDENCE, INC. is 1134217037

Main info

Organization
Name
PHOENIX RESIDENCE, INC.
NPI
1134217037
Phone
(651) 227-7655
Address
330 MARIE AVE E
Authorized Official
DARLENE M SCOTT PRESIDENT/CEO
Enumeration Date
10 October 2006
Last Update Date
1 July 2008
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for PHOENIX RESIDENCE, INC.

  • 330, Marie Avenue East, West Saint Paul, Dakota County, Minnesota, 55118, United States

    WEST ST PAUL, MN 551184011

    Phone: (651) 227-7655

    Fax: (651) 227-6847

    Type: Mailing

  • 1685, Howard Street, Maplewood, Ramsey County, Minnesota, 55109, United States

    MAPLEWOOD, MN 55109

    Phone: (651) 777-6754

    Fax: (651) 779-9339

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55118)

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Reviews

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Frequently asked questions

What identifier follows PHOENIX RESIDENCE, INC. across health systems?
The NPI 1134217037 uniquely identifies PHOENIX RESIDENCE, INC. in U.S. healthcare data.
Is PHOENIX RESIDENCE, INC.'s NPI status active today?
Active status means PHOENIX RESIDENCE, INC.'s NPI record is not deactivated in the public file.
What does the directory say PHOENIX RESIDENCE, INC. does?
Insurance directories may phrase it differently, but here PHOENIX RESIDENCE, INC. maps to Intellectual Disabilities Intermediate Care Facility. Clinical services aligned with this taxonomy classification.
What geographic area is tied to PHOENIX RESIDENCE, INC.?
PHOENIX RESIDENCE, INC. is associated with West St Paul, Minnesota in the same public data insurers reference.
Why is information missing for PHOENIX RESIDENCE, INC.?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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