Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PHOENIX RESIDENCE, INC.
Active OrganizationPHOENIX RESIDENCE, INC. is a ICF/Individuals with Intellectual Disabilities organization located in LITTLE CANADA, Minnesota. NPI 1376649673 is currently active in the NPPES registry. Verify at CMS.
ICF/Individuals with Intellectual Disabilities · LITTLE CANADA, MN
Registration Details
- NPI Number
- 1376649673
- Provider Type
- Organization
- NPI Issued
- Sep 15, 2006 (19.952903604053 yrs)
- Last Updated
- Jul 1, 2008
- License
-
1033704 1 RS (MN)
Practice Information
- Address
-
645 VIKING DR ELITTLE CANADA, MN, 551171663Browse MN providers · Browse ZIP 55117
- Phone
- 6512942076
- Fax
- 6512942077
- Primary Specialty
-
ICF/Individuals with Intellectual Disabilities
315P00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.