Phoenix Residence, Inc.
NPI 1649376005 · Intellectual Disabilities Intermediate Care Facility · Mounds View, MN
Phoenix Residence, Inc. is a Intellectual Disabilities Intermediate Care Facility organization in Mounds View, MN (NPI 1649376005).
Provider details
- NPI number
- 1649376005
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Scott Darlene, President/Ceo(651) 227-7655
- License
- 1032532 1 RS (MN)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-15
- Last updated
- 2008-07-01
Frequently asked questions
- What is Phoenix Residence, Inc.'s NPI number?
- Phoenix Residence, Inc.'s National Provider Identifier (NPI) is 1649376005, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Phoenix Residence, Inc.?
- Phoenix Residence, Inc. is classified in the NPPES registry as Intellectual Disabilities Intermediate Care Facility (Nursing & Custodial Care Facilities).
- Where is Phoenix Residence, Inc. located?
- Phoenix Residence, Inc.'s practice location on file with NPPES is 7717 Long Lake Rd, Mounds View, MN 55112-6205.
- What is Phoenix Residence, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Phoenix Residence, Inc. is (763) 398-3812.
- Who is the authorized official for Phoenix Residence, Inc.?
- The authorized official listed on Phoenix Residence, Inc.'s NPPES record is Scott Darlene, President/Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Phoenix Residence, Inc.'s NPI active?
- Yes — Phoenix Residence, Inc.'s NPI (1649376005) is active in the NPPES registry as of the last update on 2008-07-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.