THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM


Address: 11065 Village Road, Chaska, MN 55318
Phone: 9529609715

THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM (NPI# 1487785234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487785234
Entity Type Organization
Organization Name THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM
Other Organization Name SALVATION ARMY BEACON MATRIX PROGRAM IN CARVER COUNTY
Practice Address 11065 Village Road
Chaska
MN 55318
Mailing Address 1010 Currie Ave
Minneapolis
MN 55403-1309
Practice Telephone 9529609715
Practice Fax Number 9529609714
Mailing Telephone 6123380113
Mailing Fax Number 6123384717
Enumeration Date 2007-03-07
Last Update Date 2020-08-22
Authorized Official Name DAVID TINKIS (CHIEF OPERATING OFFICER)
Authorized Official Telephone 6127673102
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 324500000X Substance Abuse Rehabilitation Facility 1042208-1-CDT MN Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MN 597555700 05

Other Provider/Organization Names

Other Name Type Code
Salvation Army Beacon Matrix Program in Carver County Doing Business As Name - Organization

Office Location

Street Address 11065 VILLAGE ROAD
City CHASKA
State MN
Zip Code 55318

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548742968 Elizabeth Ann Root Counselor 111 Hundertmark Rd Suite 450, Chaska, MN 55318 2018-09-01
1972002244 Ruth Ann Plante Counselor 510 Chestnut Street Suite 201, Chaska, MN 55318 2018-02-01
1265959795 Bhatti Gi Surgery Center LLC Clinic/Center 1447 White Oak Dr, Chaska, MN 55318 2017-08-25
1194241166 Five Stars Recovery Center Clinical Medical Laboratory 1045 Stoughton Ave., Chaska, MN 55318 2017-08-21
1306383419 Laurie Ann Sisser Registered Nurse 123 W. 3rd Street, Suite #1, Forever Life Home Health Care, Chaska, MN 55318 2017-01-26
1942756671 David Erlandson Physical Therapist 110105 Pioneer Trail, #201, Chaska, MN 55318 2016-09-01
1912319286 Chaska Commons Dental Group PC Dentist 114 Pioneer Trail, Chaska, MN 55318 2014-05-21
1063546620 Laura Lee Bergjord Social Worker 600 East 4th St, Chaska, MN 55318 2007-03-15
1184758740 Jennifer Ann Mueller Social Worker 401 East Fourth Street, Chaska, MN 55318 2007-03-15
1871656975 John Monrath Posselt Dentist 1580 White Oak Dr, #275, Chaska, MN 55318 2006-12-19
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Taxonomy Information

Taxonomy Code 324500000X
Grouping Residential Treatment Facilities
Classification Substance Abuse Rehabilitation Facility

Taxonomy Definition

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.
Notes: [7/1/2003: modified title, modified definition]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1255948584 Sober Living Connection Substance Abuse Rehabilitation Facility 11115 Minnetonka Blvd, Hopkins, MN 55305 2020-09-30
1730791393 Crecer Services Substance Abuse Rehabilitation Facility 220 Robert St S Ste 103, Saint Paul, MN 55107-1626 2020-08-17
1801405584 Bridge Recovery LLC Substance Abuse Rehabilitation Facility 1485 10th Avenue Ne, Sauk Rapids, MN 56379-9838 2020-07-28
1710505821 Rrecovery Services Substance Abuse Rehabilitation Facility 867 Pierce Butler Rte, Saint Paul, MN 55104-1522 2020-07-06
1912520966 Avenues, LLC Substance Abuse Rehabilitation Facility 1990 Suburban Ave Ste 2000, Saint Paul, MN 55119-7001 2020-05-26
1962022939 Valley View Recovery Center Inc. Substance Abuse Rehabilitation Facility 31591 64th Ave, Cannon Falls, MN 55009-4296 2020-04-20
1801420039 Recovery Center LLC Substance Abuse Rehabilitation Facility 109 W James St, Paynesville, MN 56362-1216 2020-02-26
1336772425 Northern Minnesota Addiction Wellness Center Substance Abuse Rehabilitation Facility 4851 Stacy Ann Dr Nw, Bemidji, MN 56601 2020-02-17
1386277622 Community of Recovering People Substance Abuse Rehabilitation Facility 1221 Wayzata Blvd E, Wayzata, MN 55391-1942 2020-02-14
1992366645 One Touch of Christ Evangelistic Ministries Substance Abuse Rehabilitation Facility 5701 Shingle Creek Pkwy Ste 650, Brooklyn Center, MN 55430-2492 2019-06-24
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Competitor

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City CHASKA
Zip Code 55318

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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