Active NPI
Skyline Mental Health Services LLC
- Clinic/Center
- Maple Grove, MN
National Provider Identifier
1174379176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- SKYLINE MENTAL HEALTH SERVICES LLC
- Practice address
- 10944 Quantico LN N
Maple Grove, MN 55369-7527 - Phone
- (763) 445-4693
- NPI assigned
- Apr 29, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Busayo Okusanya
- Title
- Owner
- Phone
- (763) 268-9552
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
10944 Quantico LN N
Maple Grove, MN 55369-7527
Mailing address
10944 Quantico LN N
Maple Grove, MN 55369-7527
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714348800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1765152000000",
"number": "1174379176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10944 QUANTICO LN N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553697527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10944 QUANTICO LN N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553697527",
"telephone_number": "763-445-4693"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SKYLINE MENTAL HEALTH SERVICES LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-29",
"last_updated": "2025-12-08",
"certification_date": "2025-12-08",
"status": "A",
"authorized_official_last_name": "OKUSANYA",
"authorized_official_first_name": "BUSAYO",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "763-268-9552"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.