PHOENIX SERVICE CORPORATION NPI 1881645067

NPI Information

NPI: 1881645067
Provider Name: PHOENIX SERVICE CORPORATION
Classification: Case Management - 251B00000X
Entity Type: Organization
CLIA Number: 24D2086651
Address: 330 MARIE AVE E
WEST ST PAUL, MN
ZIP 55118
Phone: (651) 227-7655

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NPI Details

PHOENIX SERVICE CORPORATION is a case management in West St Paul, MN. The provider is an organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. PHOENIX SERVICE CORPORATION NPI is 1881645067. The provider is registered as an organization entity type.

The provider's business location address is:

330 MARIE AVE E
WEST ST PAUL, MN
ZIP 55118-011
Phone: (651) 227-7655
Fax: (651) 227-6847

The provider's authorized official is Darlene M Scott .
The authorized official title is President/ceo and has the following contact phone number (651) 227-7655.

The CLIA number assigned to this NPI record is 24D2086651 - other - 245d provider with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/13/2006 and was last updated on 7/17/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	1014199-1-WS	MINNESOTA	No
2	251J00000X	Nursing Care		MINNESOTA	No
3	251S00000X	Community/Behavioral Health	1069741-1-HCBS	MINNESOTA	No
4	251B00000X	Case Management	1069741-1-HCBS	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	596555100	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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