Healthcare Provider Details

I. General information

NPI: 1568224707
Provider Name (Legal Business Name): BEACON COMMUNITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8014 OVERMONT RIDGE RD
BLACKLICK OH
43004-8261
US

IV. Provider business mailing address

8014 OVERMONT RIDGE RD
BLACKLICK OH
43004-8261
US

V. Phone/Fax

Practice location:
  • Phone: 614-756-1588
  • Fax:
Mailing address:
  • Phone: 614-756-1588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. RESHUNDA L GLOVER
Title or Position: ADMINISTRATOR
Credential:
Phone: 614-756-1588