Healthcare Provider Details

I. General information

NPI: 1275585564
Provider Name (Legal Business Name): ANOKA METRO REGIONAL TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 7TH AVE
ANOKA MN
55303-4516
US

IV. Provider business mailing address

3301 7TH AVE
ANOKA MN
55303-4516
US

V. Phone/Fax

Practice location:
  • Phone: 763-712-4000
  • Fax:
Mailing address:
  • Phone: 651-431-5000
  • Fax: 651-431-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number331056
License Number StateMN

VIII. Authorized Official

Name: LYNN GLANCEY
Title or Position: CFO
Credential:
Phone: 651-539-7200