1710097274 LIFESPAN OF MINNESOTA, INC.
Mental Health Clinic/Center (Including Community Mental Health Center)
Active
Basic Information
- Organization Name
- LIFESPAN OF MINNESOTA, INC.
- Enumeration Date
- August 30, 2006
- Last Update
- July 21, 2022
- Authorized Official
- MRS. TRACI LEE HACKMANN MA LP
CEO/CLINICAL DIRECTOR
Phone: (952) 562-8500
Practice Location
- Address
- 12425 RIVER RIDGE BLVD
#200
BURNSVILLE, MN 553374871 - Phone
- (952) 562-8500
- Fax
- (952) 562-8501
Mailing Address
- Address
- 12425 RIVER RIDGE BLVD
#200
BURNSVILLE, MN 553374871 - Phone
- (952) 562-8500
- Fax
- (952) 562-8501
Specialties & Taxonomies
| Specialty | Code | Classification | License | State | Primary |
|---|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) Mental Health (Including Community Mental Health Center) | 261QM0801X | Clinic/Center | 7876190 00 | MN | No |
| Mental Health Clinic/Center (Including Community Mental Health Center) Mental Health (Including Community Mental Health Center) | 261QM0801X | Clinic/Center | 7076053 00 | MN | Primary |
Other Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 454T4DA | 01 | MN | BLUE CROSS BLUE SHIELD |
| 102020 | 01 | MN | UCARE |
| 100598 | 01 | MN | HEALTHPARTNERS |
| 707605300 | 05 | MN | N/A |
| 787619000 | 05 | MN | N/A |
Additional Practice Locations
13000 63rd Ave N
Maple Grove, MN 553696081
Maple Grove, MN 553696081
Phone: (763) 553-4003
Fax: (763) 553-7743
Frequently Asked Questions
What is LIFESPAN OF MINNESOTA, INC.'s NPI number?
LIFESPAN OF MINNESOTA, INC.'s NPI number is 1710097274.
Which doctor has NPI number 1710097274?
The doctor with NPI number 1710097274 is LIFESPAN OF MINNESOTA, INC..
What is LIFESPAN OF MINNESOTA, INC.'s practice address?
LIFESPAN OF MINNESOTA, INC.'s practice address is 12425 RIVER RIDGE BLVD, #200, BURNSVILLE, MN, 553374871.
Which doctor practices at 12425 RIVER RIDGE BLVD, #200, BURNSVILLE, MN, 553374871?
LIFESPAN OF MINNESOTA, INC. practices at 12425 RIVER RIDGE BLVD, #200, BURNSVILLE, MN, 553374871.
What is LIFESPAN OF MINNESOTA, INC.'s phone number?
LIFESPAN OF MINNESOTA, INC.'s phone number is (952) 562-8500.
Who is (952) 562-8500?
(952) 562-8500 is the phone number for LIFESPAN OF MINNESOTA, INC..
What is LIFESPAN OF MINNESOTA, INC.'s specialty?
LIFESPAN OF MINNESOTA, INC.'s specialty is Mental Health Clinic/Center (Including Community Mental Health Center).
What type of doctor is LIFESPAN OF MINNESOTA, INC.?
LIFESPAN OF MINNESOTA, INC. is a Mental Health Clinic/Center (Including Community Mental Health Center).
Is LIFESPAN OF MINNESOTA, INC. a Mental Health (Including Community Mental Health Center)?
Yes, LIFESPAN OF MINNESOTA, INC. is a Mental Health (Including Community Mental Health Center).
Is LIFESPAN OF MINNESOTA, INC. still practicing?
Yes, LIFESPAN OF MINNESOTA, INC. is currently practicing.
Is LIFESPAN OF MINNESOTA, INC. accepting new patients?
LIFESPAN OF MINNESOTA, INC. may be accepting new patients. Please call their office at (952) 562-8500 to inquire about availability.
Is NPI 1710097274 still active?
Yes, NPI 1710097274 is currently active.
Where does LIFESPAN OF MINNESOTA, INC. practice?
LIFESPAN OF MINNESOTA, INC. practices in BURNSVILLE, MN.