Provider Demographics
NPI:1114051844
Name:BEACON ARMS ASSISTED LIVING CENTER
Entity Type:Organization
Organization Name:BEACON ARMS ASSISTED LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-747-8100
Mailing Address - Street 1:1328 SE 2ND ST
Mailing Address - Street 2:P.O BOX 809
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-2014
Mailing Address - Country:US
Mailing Address - Phone:252-747-8100
Mailing Address - Fax:252-747-8206
Practice Address - Street 1:1328 SE 2ND ST
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-2014
Practice Address - Country:US
Practice Address - Phone:252-747-8100
Practice Address - Fax:252-747-8206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL-040-002310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility