OrganizationActive
Phoenix Residence, Inc.
NPI 1831285816 · Intellectual Disabilities Intermediate Care Facility · Vadnais Heights, MN
Provider details
- NPI number
- 1831285816
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Darlene Scott, President/Ceo(651) 227-7655
- License
- 805117 (MN)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1336 E County Road E
Vadnais Heights, MN 55110
Phone: (651) 484-3278
Fax: (651) 484-2792
Approximate (ZIP-level) locationGet directions
Mailing address
330 Marie Ave E
West St Paul, MN 55118-4011
Registry dates
- Enumerated
- 2006-10-05
- Last updated
- 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.