NPIMap

Organization Active NPI

Clifton House Inc

  • Religious Nonmedical Health Care Institution
  • New Brighton, MN
National Provider Identifier
1063746790
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical Health Care InstitutionTaxonomy code 282J00000X
License
345904 Issued in MN
Legal business name
CLIFTON HOUSE INC
Practice address
1200 Long Lake Road
New Brighton, MN 55112-6430
Phone
(651) 379-0100
Fax
(651) 379-0601
NPI assigned
Sep 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Suzanne GivensNPI 1174986681
Title
Administrator
Phone
(651) 379-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Health Care Institution 282J00000X 345904 MN Primary

Addresses

Primary practice location

1200 Long Lake Road
New Brighton, MN 55112-6430

Mailing address

1200 Long Lake Road
New Brighton, MN 55112-6430
Phone (651) 379-0100

Other names 1

  • Beacon Haven Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091106000287 MN Part A Provider - Religious Non-Medical Health Care Institution (Rnhci) 5294710067 Practice locations: New Brighton, MN

Hospital certification: CCN 241991

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BEACON HAVEN
Certification status
Active
Provider type (POS)
Hospital – Religious non-medical health care institution
Participating since
Nov 12, 2010
Last certification
Sep 21, 2010
Beds
8 (6 certified)
Ownership / control type
Church
Facility address
1200 Long Lake Road
New Brighton, MN 55112

National Provider Directory

National Provider Directory

Locations

1200 Long Lake Rd
Saint Paul, MN 55112
Phone (651) 379-0100

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1063746790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 LONG LAKE ROAD",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126430",
            "telephone_number": "651-379-0100",
            "fax_number": "651-379-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LONG LAKE ROAD",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126430",
            "telephone_number": "651-379-0100",
            "fax_number": "651-379-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFTON HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "GIVENS",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "651-379-0100"
    },
    "taxonomies": [
        {
            "code": "282J00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Health Care Institution",
            "state": "MN",
            "license": "345904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Haven",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Brighton, MN

Sources for this page

Verify at the official NPI Registry.