# MINNESOTA SEX OFFENDER PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MOOSE LAKE REGIONAL STATE OPERATED SERVICES
- **Other names:** Moose Lake Regional State Operated Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730354549
- **Legal business name:** MOOSE LAKE REGIONAL STATE OPERATED SERVICES
- **Authorized official:** LYNN GLANCEY (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (651) 539-7200

## Contact information

- **Practice address:** 1111 HIGHWAY 73, MOOSE LAKE, MN 55767-9452
- **Practice address phone:** (218) 485-5300
- **Mailing address:** 3200 LABORE RD., SUITE 104, VADNAIS HEIGHTS, MN 55110-5186
- **Mailing address phone:** (651) 539-7200
- **Mailing address fax:** (651) 431-7505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 339327 | MN | Yes |

## Other

- **Enumeration date:** 04/23/2008
- **Last updated:** 01/07/2026