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General NPI Number Information
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NPI Number | 1205300613
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Entity Type | Organization
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Legal Business Name | BEACON SOLUTION
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 52055 PLUM CREEK DR
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City | CHESTERFIELD
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State | MI
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Zip | 48047-5977
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Country | US
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Telephone | 586-443-3901
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Fax |
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Provider Business Mailing Address
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Address Line | 52055 PLUM CREEK DR
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City | CHESTERFIELD
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State | MI
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Zip | 48047-5977
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Country | US
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Telephone | 586-443-3901
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MRS. GLENDA COOPER
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Credential | BS
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Telephone | 586-443-3901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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