MEDICARE: BEACON GROUP, INC.

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	251C00000X	Developmentally Disabled Services Day Training Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1801622501
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACON GROUP, INC.

Provider Business Mailing Address
First Line	:	308 W GLENN ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-4433
Country	:	US
Telephone Number	:	520-622-4874
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 N STONE AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85705-5072
Country	:	US
Telephone Number	:	520-622-4874
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	NATALYA BROWN
Credential	:
Telephone Number	:	520-622-4874

Provider Enumeration Date	:	09/10/2024
Last Update Date	:	09/10/2024

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Directions to “BEACON GROUP, INC. ” Practice Location

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