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Organization
MINNESOTA SEX OFFENDER PROGRAM
Active
Organization
MINNESOTA SEX OFFENDER PROGRAM
Active
Parent organization
MOOSE LAKE REGIONAL STATE OPERATED SERVICES
Other names
Moose Lake Regional State Operated Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOOSE LAKE REGIONAL STATE OPERATED SERVICES
Authorized official
LYNN GLANCEY (CHIEF FINANCIAL OFFICER)
(651) 539-7200
Entity
Organization
Contact information
Practice address
1111 HIGHWAY 73, MOOSE LAKE, MN 55767-9452
(218) 485-5300
Mailing address
3200 LABORE RD., SUITE 104, VADNAIS HEIGHTS, MN 55110-5186
(651) 539-7200
(651) 431-7505
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
339327
MN
Other
Enumeration date
04/23/2008
Last updated
01/07/2026
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