Minnesota Specialty Health Systems-Brainerd

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

353355 Issued in MN

Legal business name

MINNESOTA SPECIALTY HEALTH SYSTEMS-BRAINERD

Practice address

11615 State Ave
Brainerd, MN 56401-7306

Phone

(218) 828-2718

Fax

(218) 828-2569

NPI assigned

Aug 1, 2011

Organization subpart

No

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

Addresses

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1609154178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 LABORE RD STE 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": "11615 STATE AVE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564017306",
            "telephone_number": "218-828-2718",
            "fax_number": "218-828-2569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA SPECIALTY HEALTH SYSTEMS-BRAINERD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "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": "353355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel S. Miller, D.D.S.
• Pamela Miller, OTR
• Mary Darlene Millicent, LICSW
• Paul Milloy
• Minnesota Neurorehabilitaion Hospital
• Minnesota State Colleges and Universities
• Minnesota Teen Challenge, Inc
• Minnesota Teen Challnge, Inc.
• Mjheldt Inc
• Rolf P Moen, DDS

• Mental Illness Community Based Residential Treatment Facility in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Mental Illness Community Based Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.