Minnesota Sex Offender Program
NPI #1730354549 in Moose Lake, Minnesota
Provider Information
- NPI Number
- 1730354549
- Entity Type
- Organization
- Organization Name
- Minnesota Sex Offender Program
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MOOSE LAKE REGIONAL STATE OPERATED SERVICES
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Apr 23, 2008
- Last Updated
- Jan 7, 2026
Practice Location
- Address
- 1111 HIGHWAY 73
- City
- Moose Lake
- State
- Minnesota
- ZIP Code
- 55767-9452
- Phone
- (218) 485-5300
Authorized Official
- Name
- LYNN GLANCEY
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (651) 539-7200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Residential Treatment Facility |
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