PHOENIX GROUP HOMES, INC. (NPI# 1841417144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841417144 |
| Entity Type | Organization |
| Organization Name | PHOENIX GROUP HOMES, INC. |
| Practice Address |
1936 Craig Pl Maplewood MN 55109-2844 |
| Mailing Address |
1011 Interlachen Pkwy Woodbury MN 55125-8852 |
| Practice Telephone | 6517484031 |
| Practice Fax Number | 6517484043 |
| Mailing Telephone | 6512300849 |
| Mailing Fax Number | 6517735894 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. WENDY JEAN SPARKS (ASSISTANT DIRECTOR) |
| Authorized Official Telephone | 6512300849 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 177F00000X | Lodging | 1037126-1 | MN | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003022518 | Phoenix Group Homes, Inc. | Lodging | 20898 130th St, New Richland, MN 56072-3501 | 2007-05-14 |
| 1811100282 | Phoenix Group Homes, Inc. | Lodging | 2371 Highwood Ave E, Maplewood, MN 55119-5801 | 2007-05-08 |
| 1164675344 | Phoenix Group Homes, Inc. | Community/Behavioral Health | 227 E Main St, Suite 105, Mankato, MN 56001-7732 | 2008-10-31 |
| Street Address |
1936 CRAIG PL |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-2844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 177F00000X |
| Grouping | Other Service Providers |
| Classification | Lodging |
| A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811100282 | Phoenix Group Homes, Inc. | Lodging | 2371 Highwood Ave E, Maplewood, MN 55119-5801 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122758 | Kmjv Operation LLC | Lodging | 19351 Indiana Ave, Lakeville, MN 55044-4849 | 2020-10-23 |
| 1396395349 | Jerald Mitchell | Lodging | 120 3rd Ave N, Biwabik, MN 55708-3032 | 2019-09-11 |
| 1124687322 | Thibodeaux Real Estate Conglomerate | Lodging | 4245 Golden Valley Rd, Golden Valley, MN 55422-4215 | 2019-06-11 |
| 1417416504 | The Chestnut Burrow | Lodging | 423 Chestnut St, Virginia, MN 55792-2525 | 2019-03-18 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1558874743 | Kelly-norton Programs, Inc. | Lodging | 1928 Stevens Ave, Minneapolis, MN 55403-3835 | 2017-11-09 |
| 1114441987 | Darlene Benson | Lodging | 22383 Nebish Rd Ne, Blackduck, MN 56630-5138 | 2017-08-02 |
| 1972816155 | Erie Beehler | Lodging | 12407 Parkwood Ln Nw, Bemidji, MN 56601-6178 | 2010-07-16 |
| 1487966115 | Michele Astrup | Lodging | 21251 Co 35, Underwood, MN 56586 | 2010-07-10 |
| 1336466614 | Kristin Zachman | Lodging | 5080 Naber Ave Ne, Saint Michael, MN 55376-9424 | 2010-04-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.