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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 Specialty Code Provider Type

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

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

NPI # 1487785234
LBN Legal business name THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM
Authorized official DAVID TINKIS - (CHIEF OPERATING OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/07/2007
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN License # 1042208-1-CDT
MN Medicaid 597555700
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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