NPIMap

Organization Active NPI

Phoenix Group Homes, Inc.

  • Lodging Provider
  • Maplewood, MN
National Provider Identifier
1811100282
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lodging ProviderTaxonomy code 177F00000X
License
1037126-2-DCFC Issued in MN
Legal business name
PHOENIX GROUP HOMES, INC.
Practice address
2371 Highwood Ave E
Maplewood, MN 55119-5801
Phone
(651) 773-1142
Fax
(651) 773-5894
NPI assigned
May 8, 2007
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
Mrs. Wendy Jean Sparks
Title
Assistant Director
Phone
(651) 230-0849

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lodging ProviderGroup: 193400000X SINGLE SPECIALTY GROUP 177F00000X 1037126-2-DCFC MN Primary

Addresses

Primary practice location

2371 Highwood Ave E
Maplewood, MN 55119-5801

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": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811100282",
    "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": "2371 HIGHWOOD AVE E",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551195801",
            "telephone_number": "651-773-1142",
            "fax_number": "651-773-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "651-230-0849",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lodging",
            "state": "MN",
            "license": "1037126-2-DCFC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, 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.