Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PHOENIX RESIDENCE, INC.
Active OrganizationICF/Individuals with Intellectual Disabilities · WHITE BEAR LAKE, MN
Registration Details
- NPI Number
- 1457458812
- Provider Type
- Organization
- NPI Issued
- Sep 20, 2006 (19.586221631412 yrs)
- Last Updated
- Jul 1, 2008
- License
-
1032511 1 RS (MN)
Practice Information
- Address
-
2168 12TH STREETWHITE BEAR LAKE, MN, 55110Browse MN providers · Browse ZIP 55110
- Phone
- 6516533713
- Fax
- 6516535784
- Primary Specialty
-
ICF/Individuals with Intellectual Disabilities
315P00000X
Other ICF/Individuals with Intellectual Disabilities Organizations in WHITE BEAR LAKE, MN
| Name | NPI |
|---|---|
| AXIS MINNESOTA, INC. | 1265596886 |
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.