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General NPI Number Information
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NPI Number | 1326429630
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Entity Type | Organization
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Legal Business Name | BEACON PLACE LLC
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 06/11/2015
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Provider Practice Location Address
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Address Line | 583 STATE ROUTE 32 5U
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City | HIGHLAND MILLS
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State | NY
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Zip | 10930-5200
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Country | US
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Telephone | 845-928-2642
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Fax | 845-928-2989
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Provider Business Mailing Address
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Address Line | 583 STATE ROUTE 32 5U
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City | HIGHLAND MILLS
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State | NY
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Zip | 10930-5200
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Country | US
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Telephone | 845-928-2642
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Fax | 845-928-2989
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | SOLMON LEBOVITS
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Credential |
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Telephone | 845-928-2642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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