| Beacon Specialized Living Minnesota, Inc. | |
|
1355 Mendota Heights Road Suite 260 Mendota Heights MN 55120 | |
| (651) 451-2889 | |
| (651) 451-5955 |
| Full Name | Beacon Specialized Living Minnesota, Inc. |
|---|---|
| Speciality | Clinic/center - Adult Day Care |
| Location | 1355 Mendota Heights Road, Mendota Heights, Minnesota |
| Authorized Official Name and Position | Barbara Turner (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Contact | 6514512889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Specialized Living Minnesota, Inc. 1355 Mendota Heights Road Suite 260 Mendota Heights MN 55120 Ph: (651) 451-2889 | Beacon Specialized Living Minnesota, Inc. 1355 Mendota Heights Road Suite 260 Mendota Heights MN 55120 Ph: (651) 451-2889 |
| NPI Number | 1528174349 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 07/26/2021 |
| Certification Date | 07/26/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528174349 | NPI | - | NPPES |
| 706520500 | Medicaid | MN | |
| 211817300 | Medicaid | MN | |
| 108343100 | Medicaid | MN | |
| 24G272 | Medicaid | MN | |
| 196680400 | Medicaid | MN | |
| 246318 | Other | MN | MEDICAID |
| 339343700 | Medicaid | MN | |
| 392150600 | Medicaid | MN | |
| 579133200 | Medicaid | MN |
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