MSOCS-SWAN LAKE NPI 1558434399

NPI Information

NPI: 1558434399
Provider Name: MSOCS-SWAN LAKE
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
1423 SWAN LAKE RD
DULUTH, MN
ZIP 55811
Phone: (218) 722-9449
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MSOCS-SWAN LAKE is an intermediate care facility mentally retarded in Duluth, MN. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MSOCS-SWAN LAKE NPI is 1558434399. The provider is registered as an organization entity type.

The provider's business location address is:

1423 SWAN LAKE RD
DULUTH, MN
ZIP 55811-606
Phone: (218) 722-9449

The provider's authorized official is Roger Deneen .
The authorized official title is Residential Prog Svcs Director and has the following contact phone number (651) 582-1857.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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