Lifespan of Minnesota, Inc.
NPI 1710097274 · Mental Health Clinic/Center (Including Community Mental Health Center) · Burnsville, MN
Lifespan of Minnesota, Inc. is a Mental Health Clinic/Center (Including Community Mental Health Center) organization in Burnsville, MN (NPI 1710097274).
Provider details
- NPI number
- 1710097274
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Traci Hackmann, Ceo/Clinical Director(952) 562-8500
- License
- 7876190 00 (MN)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense 7076053 00 (MN)
Ambulatory Health Care Facilities
- Mental Health Clinic/Center (Including Community Mental Health Center)261QM0801XLicense 7876190 00 (MN)
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Additional practice locations (1)
- 13000 63rd Ave NMaple Grove, MN 55369-6081Phone: (763) 553-4003Fax: (763) 553-7743
Registry dates
- Enumerated
- 2006-08-30
- Last updated
- 2022-07-21
Frequently asked questions
- What is Lifespan of Minnesota, Inc.'s NPI number?
- Lifespan of Minnesota, Inc.'s National Provider Identifier (NPI) is 1710097274, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lifespan of Minnesota, Inc.?
- Lifespan of Minnesota, Inc. is classified in the NPPES registry as Mental Health Clinic/Center (Including Community Mental Health Center) (Ambulatory Health Care Facilities).
- Where is Lifespan of Minnesota, Inc. located?
- Lifespan of Minnesota, Inc.'s practice location on file with NPPES is 12425 River Ridge Blvd, Burnsville, MN 55337-4871.
- What is Lifespan of Minnesota, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Lifespan of Minnesota, Inc. is (952) 562-8500.
- Who is the authorized official for Lifespan of Minnesota, Inc.?
- The authorized official listed on Lifespan of Minnesota, Inc.'s NPPES record is Traci Hackmann, Ceo/Clinical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lifespan of Minnesota, Inc.'s NPI active?
- Yes — Lifespan of Minnesota, Inc.'s NPI (1710097274) is active in the NPPES registry as of the last update on 2022-07-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.