MSOCS-MOOSE LAKE
NPI 1205909991
Intermediate Care Facility, Intellectual Disabilities in Moose Lake, MN

Q: What is Msocs-Moose Lake's NPI number?

The NPI number for Msocs-Moose Lake is 1205909991. It was assigned to this organization in the NPPES registry on November 17, 2006.

Q: What is Msocs-Moose Lake's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Q: When was this NPI record last updated?

The NPPES record for Msocs-Moose Lake was last updated on June 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 17, 2006

305 4TH ST, MOOSE LAKE, MN 55767(218) 485-4634 Get Directions Write a Review

NPPES record last updated: June 18, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Msocs-moose Lake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MSOCS-MOOSE LAKE (NPI 1205909991) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Moose Lake, Minnesota and active in the NPI registry since November 2006. The organization lists Roger Deneen, Residential Prog Svcs Director, as its authorized official.

NPPES Registry Identity

NPI1205909991

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameMSOCS-MOOSE LAKE

Location Address305 4TH STMoose Lake, MN 55767

Mailing AddressPo Box 64979Saint Paul, MN 55164-0979

Phone(218) 485-4634

Organization SubpartYesParent: Eastern Minnesota State Operated Community Services

Authorized OfficialRoger DeneenResidential Prog Svcs Director · (651) 582-1857

Enumeration DateNovember 17, 2006

Last NPPES UpdateJune 18, 2008

✔ NPI 1205909991 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

305 4TH ST, Moose Lake, MN 55767

Open in Google Maps ↗

Other Identifiers 1

Medicaid303745200MN

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Msocs-Moose Lake's NPI number?

The NPI number for Msocs-Moose Lake is 1205909991. It was assigned to this organization in the NPPES registry on November 17, 2006.

Where is Msocs-Moose Lake located?

Msocs-Moose Lake is located at 305 4th St, Moose Lake, MN 55767. The listed phone number is (218) 485-4634.

What is Msocs-Moose Lake's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Msocs-Moose Lake was last updated on June 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.