BEACON SPECIALIZED LIVING SERVICES INC. NPI 1790835296

NPI Information

NPI: 1790835296
Provider Name: BEACON SPECIALIZED LIVING SERVICES, INC.
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
555 RAILROAD ST
BANGOR, MI
ZIP 49013
Phone: (269) 427-8400
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BEACON SPECIALIZED LIVING SERVICES, INC. is a residential treatment facility, intellectual and/or developmental disabilities in Bangor, MI. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. BEACON SPECIALIZED LIVING SERVICES, INC. NPI is 1790835296. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

555 RAILROAD ST
BANGOR, MI
ZIP 49013-464
Phone: (269) 427-8400
Fax: (269) 427-6027

The provider's authorized official is Ken Ratzlaff .
The authorized official title is President, Ceo and has the following contact phone number (269) 427-8400.

The enumeration date for this NPI number is 1/10/2007 and was last updated on 3/31/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Primary
1	207R00000X	Internal Medicine	No
2	251E00000X	Home Health	No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness	No
4	310400000X	Assisted Living Facility	No
5	320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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