LIFESPAN OF MINNESOTA, INC. – Mental Health Clinic/Center (Including Community Mental Health Center), NPI 1710097274

LIFESPAN OF MINNESOTA, INC. is a healthcare provider. based in Maple grove, Minnesota. specializing in Mental Health Clinic/Center (Including Community Mental Health Center). The organization holds a License No. 7876190 00 (MN). The NPI Number for LIFESPAN OF MINNESOTA, INC. is 1710097274

Main info

Organization
Name
LIFESPAN OF MINNESOTA, INC.
NPI
1710097274
Phone
(763) 553-4003
Address
13000 63rd Ave N
Authorized Official
MRS. TRACI LEE HACKMANN CEO/CLINICAL DIRECTOR MA LP
Enumeration Date
30 August 2006
Last Update Date
21 July 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:19State licenses:2Digital endpointsOther names

Provider Addresses for LIFESPAN OF MINNESOTA, INC.

  • 13000 63rd Ave N

    Maple Grove, MN 553696081

    Phone: (763) 553-4003

    Fax: (763) 553-7743

    Type: Location

  • 12425, River Ridge Boulevard, Burnsville, Dakota County, Minnesota, 55337, United States

    #200

    BURNSVILLE, MN 553374871

    Phone: (952) 562-8500

    Fax: (952) 562-8501

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

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Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55369)

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Reviews

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Frequently asked questions

What federal number belongs to LIFESPAN OF MINNESOTA, INC.?
The federal identifier for LIFESPAN OF MINNESOTA, INC. is NPI 1710097274.
Is LIFESPAN OF MINNESOTA, INC.'s NPI currently valid?
The extract we use shows LIFESPAN OF MINNESOTA, INC. as active.
What field does LIFESPAN OF MINNESOTA, INC. work in?
You can think of LIFESPAN OF MINNESOTA, INC. as practicing within Mental Health Clinic/Center (Including Community Mental Health Center). Clinical services aligned with this taxonomy classification.
Where does public data place LIFESPAN OF MINNESOTA, INC.?
The snapshot lists Maple Grove, Minnesota for LIFESPAN OF MINNESOTA, INC.; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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