Healthcare Provider Details

I. General information

NPI: 1871462838
Provider Name (Legal Business Name): BEACON OF HOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 10/30/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WESTOWN PKWY STE 200
WEST DES MOINES IA
50266-1411
US

IV. Provider business mailing address

402 BLUEBELL CT
ENGLEWOOD OH
45315-7728
US

V. Phone/Fax

Practice location:
  • Phone: 937-559-1688
  • Fax:
Mailing address:
  • Phone: 937-559-1688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NICHOLINE EFUNDEM OROCK
Title or Position: OWNER
Credential:
Phone: 937-559-1688