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Phoenix Residence, Inc.
Intellectual Disabilities Intermediate Care Facility in Vadnais Heights, Minnesota
NPI 1831285816

Phoenix Residence, Inc. is a Intellectual Disabilities Intermediate Care Facility based in West St Paul, MN. Phoenix Residence, Inc. practices in Vadnais Heights, MN. The NPI Number for Phoenix Residence, Inc. is 1831285816 and holds a License No. 805117 (Minnesota).

The current practice location address for Phoenix Residence, Inc. is 1336 E County Road E, Vadnais Heights, MN and can be reached out via phone at 651-484-3278 and via fax at 651-484-2792.

Location: 1336 E County Road E, Vadnais Heights, MN, 55118-4011
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1831285816
Provider Name
Phoenix Residence, Inc.
Credential
Provider Entity Type
Organization
Address
1336 E County Road E, Vadnais Heights, MN, 55118-4011
Phone Number
651-484-3278
Fax Number
651-484-2792
Provider Enumeration Date
10/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
384045000 05 MN
institution
Provider Business Practice Location Address Details
Address
1336 E County Road E
City
Vadnais Heights
State
Minnesota
Zip
55110
Phone Number
651-484-3278
Fax Number
651-484-2792
person
Provider Business Mailing Address Details
Address
1336 E County Road E
City
Vadnais Heights
State
Minnesota
Zip
55110
Phone Number
651-484-3278
Fax Number
651-484-2792
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
805117 (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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