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Phoenix Residence, Inc.
Intellectual Disabilities Intermediate Care Facility in Arden Hills, Minnesota
NPI 1811093206

Phoenix Residence, Inc. is a Intellectual Disabilities Intermediate Care Facility based in West St Paul, MN. Phoenix Residence, Inc. practices in Arden Hills, MN. The NPI Number for Phoenix Residence, Inc. is 1811093206 and holds a License No. 1033705 1 RS (Minnesota).

The current practice location address for Phoenix Residence, Inc. is 1769 Janet Ct, Arden Hills, MN and can be reached out via phone at 651-294-2074 and via fax at 651-294-2075.

Location: 1769 Janet Ct, Arden Hills, MN, 55118-4011
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1811093206
Provider Name
Phoenix Residence, Inc.
Credential
Provider Entity Type
Organization
Address
1769 Janet Ct, Arden Hills, MN, 55118-4011
Phone Number
651-294-2074
Fax Number
651-294-2075
Provider Enumeration Date
09/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
617609700 05 MN
institution
Provider Business Practice Location Address Details
Address
1769 Janet Ct
City
Arden Hills
State
Minnesota
Zip
55112-2861
Phone Number
651-294-2074
Fax Number
651-294-2075
person
Provider Business Mailing Address Details
Address
1769 Janet Ct
City
Arden Hills
State
Minnesota
Zip
55112-2861
Phone Number
651-294-2074
Fax Number
651-294-2075
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
1033705 1 RS (Minnesota)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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