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Msocs-moose Lake
Intellectual Disabilities Intermediate Care Facility in Moose Lake, Minnesota
NPI 1205909991

Msocs-moose Lake is a Intellectual Disabilities Intermediate Care Facility based in Saint Paul, MN. Msocs-moose Lake practices in Moose Lake, MN. The NPI Number for Msocs-moose Lake is 1205909991 and holds a License No. (Minnesota).

The current practice location address for Msocs-moose Lake is 305 4Th St, Moose Lake, MN and can be reached out via phone at 218-485-4634.

Location: 305 4Th St, Moose Lake, MN, 55164-0979
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1205909991
Provider Name
Msocs-moose Lake
Credential
Provider Entity Type
Organization
Address
305 4Th St, Moose Lake, MN, 55164-0979
Phone Number
218-485-4634
Fax Number
Provider Enumeration Date
11/17/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
303745200 05 MN
institution
Provider Business Practice Location Address Details
Address
305 4Th St
City
Moose Lake
State
Minnesota
Zip
55767
Phone Number
218-485-4634
Fax Number
person
Provider Business Mailing Address Details
Address
305 4Th St
City
Moose Lake
State
Minnesota
Zip
55767
Phone Number
218-485-4634
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
()
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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