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Contact Information

STATE OF MINNESOTA
1111 HIGHWAY 73
MOOSE LAKE, MN55767-9452
 Phone: 218-485-5300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric Residential Treatment Facility

323P00000X
Indicates primary specialty

NPI Profile & details for STATE OF MINNESOTA

NPI Number 1639355902
LBN Legal business name STATE OF MINNESOTA
Authorized official BRUCE HAWKINSON - (STATE PROGRAM ADMIN DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/16/2008
Last updated 01/16/2008 - About 18 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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