Organization
THE SALVATION ARMY HARBOR LIGHT CENTER BEACON PROGRAM
Active
Other names
Salvation Army Beacon Matrix Program in Carver County
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID TINKIS (CHIEF OPERATING OFFICER)
(612) 767-3102
Entity
Organization
Contact information
Practice address
11065 VILLAGE ROAD, CHASKA, MN 55318
(952) 960-9715
(952) 960-9714
Mailing address
1010 CURRIE AVE, MINNEAPOLIS, MN 55403-1309
(612) 338-0113
(612) 338-4717
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1042208-1-CDT
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597555700
—
MN
Enumeration date
03/07/2007
Last updated
08/22/2020
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