OrganizationActive
Msocs-Moose Lake
NPI 1205909991 · Intellectual Disabilities Intermediate Care Facility · Moose Lake, MN
Provider details
- NPI number
- 1205909991
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Eastern Minnesota State Operated Community Services
- Organization subpart
- Yes
- Authorized official
- Roger Deneen, Residential Prog Svcs Director(651) 582-1857
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
305 4th St
Moose Lake, MN 55767
Phone: (218) 485-4634
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 64979
Saint Paul, MN 55164-0979
Registry dates
- Enumerated
- 2006-11-17
- Last updated
- 2008-06-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.