Beacon Specialized Living Minnesota, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BEACON SPECIALIZED LIVING MINNESOTA, INC.

Practice address

1355 Mendota Heights Road
Suite 260
Mendota Heights, MN 55120

Phone

(651) 451-2889

Fax

(651) 451-5955

NPI assigned

Aug 22, 2006

Organization subpart

No

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

Authorized official

Name

Marlene Hernandez

Title

Revenue Cycle Director

Phone

(608) 982-9762

Specialties & licenses 2

Addresses

Other identifiers 9

Other names 1

• Owakihi, Inc. Former legal business name

Tax ID family

Beacon Specialized Living Minnesota Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Owakihi Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • South Saint Paul, MN
  • NPI 1538157847
  NPD tax ID

Locations

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1528174349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 MENDOTA HEIGHTS RD STE 260",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201168",
            "telephone_number": "651-451-2889",
            "fax_number": "651-451-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 MENDOTA HEIGHTS ROAD",
            "address_2": "SUITE 260",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "55120",
            "telephone_number": "651-451-2889",
            "fax_number": "651-451-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON SPECIALIZED LIVING MINNESOTA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "608-982-9762"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "706520500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "211817300",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108343100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24G272",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196680400",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "246318",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339343700",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "392150600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "579133200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Owakihi, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Miranda D Barker, MSW LICSW
• Juancarlos Barrientos
• Andrew Jeffrey Barrows
• Anzal Mohamed Bashir
• Heidi Bausch-Ryan, PSYD, LP
• Isabella Leigh Beahen
• Hannah Ruth Beauclaire, MSW, LICSW
• Adelynah Beaudry
• Brenda Becher, PT
• Berget Foster Care

• Assisted Living Facility in Mendota Heights, MN
• Providers in Mendota Heights, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.