Healthcare Provider Details

I. General information

NPI: 1811461734
Provider Name (Legal Business Name): BEAUMONT ASHN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 TECHNOLOGY DR STE B
TROY MI
48083-4247
US

IV. Provider business mailing address

C/O ALTERNATE SOLUTIONS HEALTH NETWORK 1050 FORRER BLVD
KETTERING OH
45420
US

V. Phone/Fax

Practice location:
  • Phone: 248-743-9500
  • Fax: 248-636-4738
Mailing address:
  • Phone: 937-395-3023
  • Fax: 937-853-0552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH KLOPSCH
Title or Position: VP LEGAL AFFAIRS
Credential:
Phone: 937-299-1111