MEDICARE: BEACON CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	3440	CO

General Provider Information

NPI Number	:	1104064732
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACON CENTER

Provider Business Mailing Address
First Line	:	3804 W PRINCETON CIR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80236-3111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3804 W PRINCETON CIR
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80236-3111
Country	:	US
Telephone Number	:	303-789-2987
Fax Number	:

Authorized Official
Title or Position	:	TREATMENT COORDINATOR
Name	:	MS. CATHI SUE VIGIL
Credential	:	MA, LPC
Telephone Number	:	303-506-6459

Provider Enumeration Date	:	02/04/2009
Last Update Date	:	02/04/2009

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Directions to “BEACON CENTER ” Practice Location

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