Healthcare Provider Details

I. General information

NPI: 1861131716
Provider Name (Legal Business Name): BEACON HILL FAMILY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 4TH AVE S
SARTELL MN
56377-4728
US

IV. Provider business mailing address

303 4TH AVE S STE A
SARTELL MN
56377-2173
US

V. Phone/Fax

Practice location:
  • Phone: 320-406-1516
  • Fax: 320-514-4423
Mailing address:
  • Phone: 320-406-1516
  • Fax: 320-514-4423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRANDON JAMES JENSEN
Title or Position: CEO
Credential:
Phone: 320-406-1516