Organization Active NPI

Skyline Mental Health Services LLC

  • Clinic/Center
  • Maple Grove, MN
National Provider Identifier
1174379176
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
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

Updated by the provider on Dec 8, 2025

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)CodeLicenseStatePrimary
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 Directory

NPI 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.

Verify at the official NPI Registry.