Lifespan Of Minnesota, Inc.

LBN: Lifespan Of Minnesota, Inc.
Lifespan Of Minnesota, Inc. is an health care organization with primary practice located at 12425 River Ridge Blvd #200, Burnsville MN 55337-4871. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Lifespan Of Minnesota, Inc. can be contacted via phone (952) 562-8500, or through Hackmann, Traci Lee via phone (952) 562-8500.

Contact Information

Primary practice address
12425 River Ridge Blvd #200 Burnsville MN 55337-4871
Phone: (952) 562-8500
Fax: (952) 562-8501
Website:
Map and Directions
Authorized official contact:
Name: Hackmann, Traci Lee MA LP
Phone: (952) 562-8500

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 7076053 00 Minnesota
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 7876190 00 Minnesota

Profile Details

NPI number 1710097274
LBN Legal business name Lifespan Of Minnesota, Inc.
DBA Doing business as
Authorized official Hackmann, Traci Lee MA LP
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2006
Last updated Jul 21st, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710097274 NPPES
Minnesota Other 454T4DA BLUE CROSS BLUE SHIELD
Minnesota Other 102020 BLUE CROSS BLUE SHIELD
Minnesota Other 100598 BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 707605300 BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 787619000 BLUE CROSS BLUE SHIELD

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