MEDICARE: BEACON WAY II LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1790974053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACON WAY II LLC

Provider Business Mailing Address
First Line	:	5658 STATE HIGHWAY J
Second Line	:
City	:	ALBANY
State	:	MO
Zip	:	64402-8113
Country	:	US
Telephone Number	:	660-726-3734
Fax Number	:	660-726-3366

Provider Business Practice Location Address
First Line	:	406 N RAILROAD ST
Second Line	:
City	:	ALBANY
State	:	MO
Zip	:	64402-2403
Country	:	US
Telephone Number	:	816-390-3840
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. EMMA J GORSLINE
Credential	:
Telephone Number	:	660-726-3734

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	07/03/2008

Similar Medicare Providers

1639010200 — MRS. SHELBI VICKERS
Practice Location Address:

28665 LINDSEY ERIN LN
ALBANY, LA
70711-2403

Practice Phone: 985-981-7343
Practice Fax:

1659422210 — MRS. PAIGE C SELLS ATC, LAT
Practice Location Address:

2403 KENILWORTH DR
ALBANY, GA
31707-3032

Practice Phone: 229-483-9073
Practice Fax:

1619006392 — MR. WILLIAM JOSEPH SELLS A.T.C.. L.A.T.C.
Practice Location Address:

2403 KENILWORTH DR
ALBANY, GA
31707-3032

Practice Phone: 229-312-8701
Practice Fax:

1932525581 — MRS. VELLETTA ANN JACKSON RN, MSN, CRRN
Practice Location Address:

611 PINE AVE
ALBANY, GA
31701-2403

Practice Phone: 229-288-3879
Practice Fax:

1275911828 — ST CLAIRE GITAU SUMAILI M.D.
Practice Location Address:

2403 OSLER CT STE A
ALBANY, GA
31707-0205

Practice Phone: 229-405-6196
Practice Fax:

1164888491 — ALBANY AREA PRIMARY HEALTH CARE, INC.
Practice Location Address:

2403 OSLER CT STE B
ALBANY, GA
31707-0205

Practice Phone: 229-639-3135
Practice Fax: 229-639-3136

Directions to “BEACON WAY II LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.