Provider Demographics
NPI:1043930340
Name:BEACON HOME CARE
Entity Type:Organization
Organization Name:BEACON HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARKET OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES-LOERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-587-8288
Mailing Address - Street 1:555 PIERCE ST STE CML 4
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1078
Mailing Address - Country:US
Mailing Address - Phone:510-526-2273
Mailing Address - Fax:
Practice Address - Street 1:555 PIERCE ST STE CML 4
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1078
Practice Address - Country:US
Practice Address - Phone:510-526-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care