State of Minnesota
NPI 1639355902 · Psychiatric Residential Treatment Facility · Moose Lake, MN
State of Minnesota is a Psychiatric Residential Treatment Facility organization in Moose Lake, MN (NPI 1639355902).
Provider details
- NPI number
- 1639355902
- Entity type
- Organization
- Primary specialty
- Psychiatric Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Bruce Hawkinson, State Program Admin Director(507) 931-7102
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2008-01-16
- Last updated
- 2008-01-16
Frequently asked questions
- What is State of Minnesota's NPI number?
- State of Minnesota's National Provider Identifier (NPI) is 1639355902, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is State of Minnesota?
- State of Minnesota is classified in the NPPES registry as Psychiatric Residential Treatment Facility (Residential Treatment Facilities).
- Where is State of Minnesota located?
- State of Minnesota's practice location on file with NPPES is 1111 Highway 73, Moose Lake, MN 55767-9452.
- What is State of Minnesota's phone number?
- The practice phone number listed in the NPPES registry for State of Minnesota is (218) 485-5300.
- Who is the authorized official for State of Minnesota?
- The authorized official listed on State of Minnesota's NPPES record is Bruce Hawkinson, State Program Admin Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is State of Minnesota's NPI active?
- Yes — State of Minnesota's NPI (1639355902) is active in the NPPES registry as of the last update on 2008-01-16.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.