MINNESOTA SEX OFFENDER PROGRAM (NPI# 1730354549) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730354549 |
| Entity Type | Organization |
| Organization Name | MINNESOTA SEX OFFENDER PROGRAM |
| Other Organization Name | MOOSE LAKE REGIONAL STATE OPERATED SERVICES |
| Practice Address |
1111 Highway 73 Moose Lake MN 55767-9452 |
| Mailing Address |
Po Box 64979 Saint Paul MN 55164-0979 |
| Practice Telephone | 2184855300 |
| Mailing Telephone | 6514313676 |
| Mailing Fax Number | 6514317505 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | JACK ERSKINE (MSOP ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 2184855300 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOOSE LAKE REGIONAL STATE OPERATED SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 339327 | MN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 679415000 | 05 |
| Other Name | Type Code |
|---|---|
| Moose Lake Regional State Operated Services | Other Name - Individual/Organization |
| Street Address |
1111 HIGHWAY 73 |
| City | MOOSE LAKE |
| State | MN |
| Zip Code | 55767-9452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023095874 | John Sutherland Barry | Internal Medicine | 1111 Highway 73, Moose Lake, MN 55767 | 2005-12-22 |
| 1922540368 | Bruce A. Beaman | Marriage & Family Therapist | 1111 Highway 73, Moose Lake, MN 55767-9452 | 2016-11-16 |
| 1386186708 | Debbie Davis | Counselor | 1111 Highway 73, Moose Lake, MN 55767-9452 | 2016-11-16 |
| 1518287481 | Jonathan Franklin Klingaman | Nurse Practitioner | 1111 Highway 73, Moose Lake, MN 55767-9452 | 2010-06-02 |
| 1811168511 | Keri Ann Ovsak | Nurse Practitioner | 1111 Highway 73, Moose Lake, MN 55767-9452 | 2008-03-20 |
| 1639355902 | State of Minnesota | Psychiatric Residential Treatment Facility | 1111 Highway 73, Moose Lake, MN 55767-9452 | 2008-01-16 |
| 1073606125 | Victoria Paulette Aldridge | Nurse Practitioner | 1111 Highway 73, Moose Lake, MN 55767-9452 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778529 | Essentia Health Moose Lake | Home Health | 30 Arrowhead Ln, Moose Lake, MN 55767 | 2020-04-09 |
| 1841775475 | Katherine Mcdowell | Social Worker | 451 Arrowhead Lane, Moose Lake, MN 55767 | 2018-09-28 |
| 1316191786 | Vision Pro | Optometrist | 125 W Arrowhead Rd, Moose Lake, MN 55767 | 2008-11-11 |
| 1265627327 | Dr. Joseph J. Jamros Optometry, Ltd. | Optometrist | 312 Elm Ave., Moose Lake, MN 55767 | 2007-09-12 |
| 1013108075 | Diane Louise Stellrecht | Psychologist | 505 3rd Street, Suite A, Moose Lake, MN 55767 | 2007-08-06 |
| 1073674529 | Downtown Dental Care Pa | Dentist | 304 Elm Ave, Moose Lake, MN 55767 | 2006-12-12 |
| 1760558399 | Joseph John Jamros | Optometrist | 312 Elm Ave, Moose Lake, MN 55767 | 2006-11-27 |
| 1205909991 | Msocs-moose Lake | Intermediate Care Facility, Mentally Retarded | 305 4th St, Moose Lake, MN 55767 | 2006-11-17 |
| 1295804482 | Moose Lake Community Hospital District | Home Health | 30 Arrowhead Lane, Moose Lake, MN 55767 | 2006-11-06 |
| 1396770772 | Sonja M. Roach | Nurse Practitioner | 4570 County Highway 61, Moose Lake, MN 55767 | 2006-07-12 |
| Find all providers in zip 55767 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639355902 | State of Minnesota | Psychiatric Residential Treatment Facility | 1111 Highway 73, Moose Lake, MN 55767-9452 | 2008-01-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861046427 | Cambia Hills of East Bethel LLC | Psychiatric Residential Treatment Facility | 900 189th Ave Ne, East Bethel, MN 55011-9542 | 2019-07-31 |
| 1992268726 | North Homes Inc. | Psychiatric Residential Treatment Facility | 1920 River Rd, Grand Rapids, MN 55744-4048 | 2019-04-09 |
| 1720584337 | John E Herman Home and Treatment Facility, LLC | Psychiatric Residential Treatment Facility | 351 14th Ave Sw, Rochester, MN 55902 | 2018-04-03 |
| 1619233459 | Arrowhead House | Psychiatric Residential Treatment Facility | 2217 South St, Duluth, MN 55812-2132 | 2012-04-05 |
| 1669544987 | Kidspeace Mesabi Academy Inc | Psychiatric Residential Treatment Facility | 200 Wanless Street, Buhl, MN 55713 | 2006-11-14 |
| 1073543344 | Rhsc | Psychiatric Residential Treatment Facility | 1491 Sherburne Ave, Saint Paul, MN 55104 | 2006-07-03 |
| 1154869832 | Direct Care and Treatment - Forensic Services | Psychiatric Residential Treatment Facility | 100 Freeman Dr, Saint Peter, MN 56082-3504 | 2017-02-02 |
| 1538603683 | Paragon Residential Treatment for Youth LLC | Psychiatric Residential Treatment Facility | 12915 63rd Ave N, Maple Grove, MN 55369-6001 | 2016-12-08 |
| 1619375235 | Linda Maxine Nielson | Psychiatric Residential Treatment Facility | 1593 Hewitt Ave, Saint Paul, MN 55104-1221 | 2014-12-13 |
| 1124032818 | Anoka Metro Regional Treatment Center | Psychiatric Residential Treatment Facility | 3301 7th Ave, Anoka, MN 55303-4516 | 2006-07-28 |
| Find all providers with the same taxonomy | ||||
| City | MOOSE LAKE |
| Zip Code | 55767 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.