NPIMap

Organization Active NPI

Beacon of Hope Autism Center LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1083433650
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
BEACON OF HOPE AUTISM CENTER LLC
Practice address
85 Livingston Ave Apt 313
Saint Paul, MN 55107-5705
Phone
(651) 363-0319
NPI assigned
Oct 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Tabita A OmarNPI 1477431930
Title
Owner
Phone
(651) 363-0319

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
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

85 Livingston Ave Apt 313
Saint Paul, MN 55107-5705

Mailing address

85 Livingston Ave Apt 313
Saint Paul, MN 55107-5705
Phone (651) 363-0319

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1083433650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 LIVINGSTON AVE APT 313",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551075705",
            "telephone_number": "651-363-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 LIVINGSTON AVE APT 313",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551075705",
            "telephone_number": "651-363-0319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON OF HOPE AUTISM CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "TABITA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-363-0319"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.