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General NPI Number Information
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NPI Number | 1851289987
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Entity Type | Organization
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Legal Business Name | BEACON SQUARE NORTHVILLE
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 40033 8 MILE RD
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City | NORTHVILLE
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State | MI
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Zip | 48167-1954
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Country | US
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Telephone | 248-349-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 5480 CORPORATE DR STE 130
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City | TROY
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State | MI
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Zip | 48098-2642
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Country | US
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Telephone | 248-833-1304
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Fax |
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Authorized Official
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Title or Position | ASSISTANT CONTROLLER
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Name | MRS. ANGELA NICOLE BELL
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Credential |
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Telephone | 248-833-1304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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