National Provider Identifier Database

THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM
11065 VILLAGE ROAD
CHASKA, MN55318
Phone: 952-960-9715
Fax: 952-960-9714
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM

NPI Number 1487785234
Legal business name
LBN
THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM
Authorized official DAVID TINKIS - (CHIEF OPERATING OFFICER)
Entity Organization
Organization subpart No
Enumeration date 03/07/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 1042208-1-CDT
  • MN Medicaid: 597555700

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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