State Of Minnesota in Moose Lake - Psychiatric Residential Treatment Facility
State Of Minnesota - NPI 1639355902
State Of Minnesota is a Psychiatric Residential Treatment Facility in Moose Lake, Minnesota. State Of Minnesota practices all healthcare services and medical treatments related to Psychiatric Residential Treatment Facility. The NPI Number for State Of Minnesota is 1639355902. The last update date is 2008-01-16.
State Of Minnesota's current location address is 1111 Highway 73, Moose Lake, Minnesota. You can contact this provider via phone number 2184855300. The mailing address for State Of Minnesota is 1111 Highway 73, Moose Lake, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | State Of Minnesota |
|---|---|
| Address | 1111 Highway 73, Moose Lake, Minnesota |
| Phone Number | 2184855300 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | STATE PROG |
|---|---|
| Authorized Official Name | Hawkinson J Bruce |
| Telephone Number | 5079317102 |
NPI Number Detail
| NPI Number | 1639355902 |
|---|---|
| Provider Enumeration Date | 2008-01-16 |
| Last Updated Date | 2008-01-16 |
Provider Mailing Address Detail
| Address | 1111 Highway 73 |
|---|---|
| City | Moose Lake |
| State | Minnesota (MN) |
| Post Code | 557679452 |
| Phone Number | 2184855300 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatric Residential Treatment Facility |
|---|---|
| Taxonomy | 323P00000X |
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Definition: A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized ps |
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What is the State Of Minnesota's 1639355902?
The State Of Minnesota's NPI (National Provider Identifier) Number is 1639355902. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the State Of Minnesota located?
The State Of Minnesota is located at 1111 Highway 73, Moose Lake, MN 557679452.
What is State Of Minnesota's specialized field of practice, and what is the corresponding taxonomy classification code?
The State Of Minnesota's area of specialization is Psychiatric Residential Treatment Facility, and the corresponding taxonomy code that categorizes this field of practice is 323P00000X.
When did the State Of Minnesota receive its 1639355902?
The State Of Minnesota was issued its 1639355902 on 2008-01-16, which is the date when the organization was assigned this unique identifier.
As of what date were the State Of Minnesota's details last updated?
The information pertaining to the State Of Minnesota, including its address, specialty, and other details, was most recently updated on 2008-01-16.