OrganizationActive
Lutheran Social Service of Minnesota
NPI 1073742383 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Leroy, MN
Provider details
- NPI number
- 1073742383
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mark Peterson, Ceo(651) 642-5990
- License
- 1054398 (MN)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 1054398 (MN)
Residential Treatment Facilities
Practice location
198 Penny Lane
Leroy, MN 55951
Phone: (507) 342-3725
Approximate (ZIP-level) locationGet directions
Mailing address
2485 Como Ave
Saint Paul, MN 55108-1445
Registry dates
- Enumerated
- 2009-07-08
- Last updated
- 2009-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.