NPIMap

Organization Active NPI

Phoenix Group Homes, Inc.

  • Lodging Provider
  • New Richland, MN
National Provider Identifier
1003022518
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lodging ProviderTaxonomy code 177F00000X
License
1037125-3-DCFC Issued in MN
Legal business name
PHOENIX GROUP HOMES, INC.
Practice address
20898 130TH St
New Richland, MN 56072-3501
Phone
(507) 465-9940
Fax
(507) 465-9941
NPI assigned
May 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Wendy J. Sparks
Title
Assistant Director
Phone
(651) 230-0849

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lodging Provider 177F00000X 1037125-3-DCFC MN Primary

Addresses

Primary practice location

20898 130TH St
New Richland, MN 56072-3501

Mailing address

1011 Interlachen Pkwy
Woodbury, MN 55125-8852
Phone (651) 230-0849

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Recovery Programs Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003022518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 INTERLACHEN PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258852",
            "telephone_number": "651-230-0849",
            "fax_number": "651-773-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20898 130TH ST",
            "city": "NEW RICHLAND",
            "state": "MN",
            "postal_code": "560723501",
            "telephone_number": "507-465-9940",
            "fax_number": "507-465-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "651-230-0849"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "MN",
            "license": "1037125-3-DCFC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Richland, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.