PHOENIX RESIDENCE, INC.

Intellectual Disabilities Intermediate Care Facility · WHITE BEAR LAKE, MN

Organization Active NPI 1457458812

Taxonomy & licensure

Specialty	Code	Primary	License	State
Intellectual Disabilities Intermediate Care Facility	315P00000X	✓	1032511 1 RS	MN

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Source: NPPES (public domain) and CMS Medicare Physician & Other Practitioners data. Not affiliated with CMS, NPPES, or any government agency.