BEACON SPECIALIZED LIVING SERVICES INC (NPI# 1518341221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518341221 |
| Entity Type | Organization |
| Organization Name | BEACON SPECIALIZED LIVING SERVICES INC |
| Other Organization Name | BEACON SPRINGS |
| Practice Address |
6418 Deans Hill Rd Ste 2 Berrien Center MI 49102-9750 |
| Mailing Address |
555 Railroad St Bangor MI 49013-1464 |
| Practice Telephone | 2694278400 |
| Mailing Telephone | 2694278400 |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |
| Authorized Official Name | GERALD WRIGHT (BUSINESS MANAGER) |
| Authorized Official Telephone | 2694278400 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEACON SPECIALIZED LIVING SERVICES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | AL110366290 | MI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | LICENSE | AL110366290 | 01 |
| Other Name | Type Code |
|---|---|
| BEACON SPRINGS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215324876 | Beacon Specialized Living Services Inc | Psychiatry & Neurology | 555 Railroad St, Bangor, MI 49013-1464 | 2015-04-22 |
| Street Address |
6418 DEANS HILL RD STE 2 |
| City | BERRIEN CENTER |
| State | MI |
| Zip Code | 49102-9750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033105549 | Lakeland Specialty Hospital | Skilled Nursing Facility | 6418 Deans Hill Rd, Berrien Center, MI 49102-9750 | 2005-09-21 |
| 1477185775 | Sarah Marie Hayslip | Peer Specialist | 6418 Deans Hill Rd, Berrien Center, MI 49102-8713 | 2020-02-05 |
| 1841771946 | Ryan Allen Lutin | Peer Specialist | 6418 Deans Hill Rd, Berrien Center, MI 49102-8713 | 2018-08-27 |
| 1497262752 | James Allen Panozzo | Counselor | 6418 Deans Hill Rd, Berrien Center, MI 49102-8713 | 2018-01-08 |
| 1770094583 | Brandy Renee Rehmel | Social Worker | 6418 Deans Hill Rd, Berrien Center, MI 49102-8713 | 2017-10-19 |
| 1386185155 | Maria Gamez | Counselor | 6418 Deans Hill Rd, Berrien Center, MI 49102-8713 | 2017-03-14 |
| 1467907477 | Amber Lynn Olando | Peer Specialist | 6418 Deans Hill Rd, Berrien Center, MI 49102-8713 | 2016-08-19 |
| 1467804104 | Michelle Johnson-mastin | Counselor | 6418 Deans Hill Rd, Berrien Center, MI 49102-8713 | 2016-07-06 |
| 1821461161 | Marilynn Moltane | Counselor | 6418 Deans Hill Rd, Berrien Center, MI 49102-9750 | 2015-11-09 |
| 1639540289 | Kimberly Anne Defields Bay | Social Worker | 6418 Deans Hill Rd, Berrien Center, MI 49102-9750 | 2015-10-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396273439 | Laura Steinke | Peer Specialist | 6418 Deans Hill Rd Ste 1, Berrien Center, MI 49102-8714 | 2017-06-02 |
| 1629637269 | Julie Ann Back | Peer Specialist | 6418 Deans Hill Rd Ste 1, Berrien Center, MI 49102-8714 | 2019-06-07 |
| 1205140696 | Merene Mathew | Pediatrics | 6416 Deans Hill Rd, Berrien Center, MI 49102-9750 | 2010-07-28 |
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144855123 | Hope Shores, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1383 E Maple Ave, Burton, MI 48529-2059 | 2020-03-10 |
| 1760030183 | Specially Made Co. LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 845 E Summerfield Glen Cir, Ann Arbor, MI 48103-9161 | 2019-08-28 |
| 1033776919 | South Coast Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 72633 M 43, South Haven, MI 49090-8734 | 2019-05-25 |
| 1275001448 | St. Jude's Assisted Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 509 S 22nd St, Escanaba, MI 49829-2247 | 2018-11-06 |
| 1457826315 | Northrop Loving Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17777 Northrop St, Detroit, MI 48219-2321 | 2018-10-08 |
| 1548745961 | Residential Opportunities Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 612 Landsdowne Ave, Portage, MI 49002-0556 | 2018-10-02 |
| 1134604051 | Unity Group II LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 63 Wood Dr, Coldwater, MI 49036-1046 | 2018-09-26 |
| 1578048401 | Unity Group V LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 69 Wood Dr, Coldwater, MI 49036-1046 | 2018-09-26 |
| 1417432337 | Unity Group IIi LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1831 Case Dr, Union City, MI 49094-9348 | 2018-09-26 |
| 1033694963 | Unity Group Iv LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 126 Gail Ann Dr, Coldwater, MI 49036-9327 | 2018-09-26 |
| Find all providers with the same taxonomy | ||||
| City | BERRIEN CENTER |
| Zip Code | 49102 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.