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State of Minnesota

Psychiatric Residential Treatment Facility in Moose Lake, MN · enumerated 2008 · authorized official Bruce Hawkinson, State Program Admin Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1639355902

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Registry record

Entity type Organization (Type 2)
Legal business name State of Minnesota
Practice address 1111 Highway 73, Moose Lake, MN, 55767
Phone (218) 485-5300
Enumeration date Jan 16, 2008
Last updated in NPPES Jan 16, 2008

Taxonomy & classification

323P00000X Psychiatric Residential Treatment Facility Residential Treatment Facilities Primary

Authorized official

Name Bruce Hawkinson
Title State Program Admin Director
Phone (507) 931-7102

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is State of Minnesota located?
The practice location on file with NPPES is in Moose Lake, MN.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-01-16. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-01-16.