Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

State of Minnesota

Organization Psychiatric Residential Treatment Facility · NPI 1639355902

State of Minnesota is a Psychiatric Residential Treatment Facility in Moose Lake, Minnesota. Registered with an NPI since 2008.

In the registry since
2008
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Practice location Address checks out

1111 Highway 73
Moose Lake, MN 55767-9452
Phone: (218) 485-5300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric Residential Treatment Facility (primary) Taxonomy 323P00000X

Record details

NPI number1639355902
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Bruce Hawkinson — State Program Admin Director · (507) 931-7102
NPI enumeratedJanuary 16, 2008
Last updated in NPPESJanuary 16, 2008
Mailing address400 Centennial Building, 658 Cedar Street, Saint Paul, MN 55155-1616

Other providers in Moose Lake