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July 2012 updated MI-IMD facility list

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July 2012 updated MI-IMD facility list Powered By Docstoc
					                  INSTITUTIONS FOR MENTAL DISEASES - MENTAL ILLNESS (MI)
  Important: compare name, address, and Prov Type when selecting a facility from a Consolidated Provider list
    NPI #                      Provider                     Address                City        St       ZIP          Phone       PT   RLVA
 1861452278   Andrew Board & Care-GRH/NH             1215 S Ninth St         Minneapolis       MN      55404      612.333.0111   00    52
 1306858196   National Deaf Academy LLC              19650 US Hwy 441        Mount Dora        FL      32757      352.735.9500   03    52
 1578717336   Park Nicollet Melrose Institute        3525 Monterey Drive     St. Louis Park    MN      55416      952.993.1990   03    52
 1679709802   Prairie St. Johns*                     510 Fourth St S         Fargo             ND      58103      701.476.7863   01    53
 1831137389   Richard P Stadter Psych Ctr*           1451 44th Av S          Grand Forks       ND      58201      701.772.2500   01    53

STATE OWNED AND OPERATED MI/IMD FACILITIES

 1275585564   Anoka-Metro RTC*                       175 Adult Inpatient Psychiatric Hospital Beds                               17    50
              3301 Seventh Ave N                     25 bed Competency Restoration Program                                       17    50
              Anoka, MN 55303-4516
              763.427.0322


 1730354549   MN Sex Offender Program (MSOP)         150 Beds                                                                    03    49
              1111 Highway 73
              Moose Lake, MN 55767-9449
              218.565.6000

 1508804683   St Peter RTC - Forensic Services       MN Security (Forensic) Hospital - 320 Beds (Not an actual hospital)         03    49
              100 Freeman Dr                         Forensic Transition Program - 90 Beds
              St Peter, MN 56082-1599                Community Preparation Service programs - 8 Beds
              507.985-2008

 1730354549   St Peter RTC - MSOP Beds               MN Sex Offender Program - 214 Beds                                          03    49
              100 Freeman Dr                         Note: These beds are considered part of the Moose Lake MSOP - use
              St Peter, MN 56082-1599                Moose Lake NPI
              507.931.7688

 1730352204   St. Peter Forensics Services Nursing Home                                                                          00    78
              100 Freeman Dr
              St. Peter, MN 56082

Note: Residents 65 and over may be eligible for MA/NM/EH while in any IMD. * Resident up to age 21 may be eligible for MA
PT= Provider Type: 00=Nursing Home: 01=Hospital: 03=IMD: 17=RTC. GRH=Group Residentil Housing: NH=Nursing Home
RLVA=RECIPIENT LIVING ARRANGMENT: 49-Forensic/MSOP; 50- RTC MI Psych Hosp; 52=Rule 36; 53= Private Psych Hosp; 78= IMD NH

				
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