Organization
BEACON SPECIALIZED LIVING MINNESOTA, INC.
Active
Other names
Owakihi, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA TURNER (VICE PRESIDENT OF OPERATIONS)
(651) 451-2889
Entity
Organization
Contact information
Practice address
1355 MENDOTA HEIGHTS ROAD, SUITE 260, MENDOTA HEIGHTS, MN 55120
(651) 451-2889
(651) 451-5955
Mailing address
1355 MENDOTA HEIGHTS ROAD, SUITE 260, MENDOTA HEIGHTS, MN 55120
(651) 451-2889
(651) 451-5955
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP2482
MN
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
310400000X
Assisted Living Facility
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
311Z00000X
Custodial Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108343100
—
MN
05
—
196680400
—
MN
05
—
211817300
—
MN
01
—
246318
MEDICAID
MN
05
—
24G272
—
MN
05
—
339343700
—
MN
05
—
392150600
—
MN
05
—
579133200
—
MN
05
—
706520500
—
MN
Enumeration date
08/22/2006
Last updated
07/26/2021
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