Organization
PHOENIX RENEWAL TREATMENT SERVICES
Active
Other names
One Twelve Treatment Facility
Organization subpart
No
Provider details
NPI number
Authorized official
CORY EDWARD SOMLAI (DIRECTOR)
(952) 529-8981
Entity
Organization
Contact information
Practice address
12401 MINNETONKA BLVD, MINNETONKA, MN 55305-3971
(952) 513-7475
(952) 426-3266
Mailing address
12401 MINNETONKA BLVD, MINNETONKA, MN 55305-3971
(952) 513-7475
(952) 426-3266
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/27/2024
Last updated
03/21/2026
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