NPIMap

Organization Active NPI

Minnesota Speciality Health Systems Willmar

  • Mental Illness Community Based Residential Treatment Facility
  • Willmar, MN
National Provider Identifier
1194014134
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
1058767-1-RMI Issued in MN
Legal business name
MINNESOTA SPECIALITY HEALTH SYSTEMS WILLMAR
Practice address
1208 Olena Ave. SE
Willmar, MN 56201
Phone
(320) 235-0900
NPI assigned
Mar 30, 2011
Last updated
Jan 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lynn Glancey
Title
Chief Financial Officer
Phone
(651) 539-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X 1058767-1-RMI MN Primary

Addresses

Primary practice location

1208 Olena Ave. SE
Willmar, MN 56201

Mailing address

3200 Labore Rd
Suite 104
Vadnais Heights, MN 55110-5186
Phone (651) 539-7200

Other practice location 1

1208 Olena Ave
Willmar, MN 56201-4766
Phone (651) 431-3676

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1194014134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 LABORE RD",
            "address_2": "SUITE 104",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551105186",
            "telephone_number": "651-539-7200",
            "fax_number": "651-431-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 OLENA AVE. SE",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-235-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1208 Olena Ave",
            "address_purpose": "LOCATION",
            "city": "Willmar",
            "state": "MN",
            "postal_code": "562014766",
            "country_code": "US",
            "telephone_number": "651-431-3676",
            "fax_number": "651-431-7505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINNESOTA SPECIALITY HEALTH SYSTEMS WILLMAR",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-30",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "GLANCEY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "651-539-7200"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MN",
            "license": "1058767-1-RMI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.