Phoenix Residence, Inc.
NPI 1457458812ActiveOrganization· Intermediate Care Facility, Intellectual Disabilities· White Bear Lake, MN
Intermediate Care Facility, Intellectual Disabilities in White Bear Lake, Minnesota, registered in NPPES in September 2006. The authorized official on file is Darlene M. Scott, President/Ceo.
Overview
| NPI | 1457458812 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 20, 2006 |
| Last updated in NPPES | Jul 1, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Intermediate Care Facility, Intellectual Disabilities Primary | 315P00000X | 1032511 1 RS | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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