PHOENIX RESIDENCE, INC.

Intermediate Care Facility, Intellectual Disabilities

Active Organization
NPI: 1376649673

Practice Address

645 VIKING DR E
Little Canada, MN 55117

Phone: (651) 294-2076

Specialties

Specialty Code Primary License
Intermediate Care Facility, Intellectual Disabilities 315P00000X Yes 1033704 1 RS (MN)

Frequently Asked Questions

NPI 1376649673 is the National Provider Identifier for PHOENIX RESIDENCE, INC., a Intermediate Care Facility, Intellectual Disabilities provider located in Little Canada, MN. This NPI was enumerated on September 15, 2006.

Quick Facts

NPI
1376649673
Type
Organization
Enumerated
Sep 15, 2006
Last Updated
Jul 1, 2008

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