National Provider Identifier Database

MSOCS JONQUIL
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

MSOCS-JONQUIL
17041 JONQUIL AVE
LAKEVILLE, MN55044-9533
Phone: 952-435-2846
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for MSOCS-JONQUIL

NPI Number 1508939323
Legal business name
LBN
MSOCS-JONQUIL
Authorized official ROGER DENEEN - (RESIDENTIAL PROG SVCS DIRECTOR)
Entity Organization
Organization subpart Yes
Enumeration date 11/17/2006
Last updated 06/18/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • MN Medicaid: 834045500

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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