Provider Demographics
NPI:1164856811
Name:BECKETT SPRINGS, LLC
Entity Type:Organization
Organization Name:BECKETT SPRINGS, LLC
Other - Org Name:BECKETT SPRINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF LICENSE AND REGULATION
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:SALEE
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:812-598-8989
Mailing Address - Street 1:8614 SHEPHERD FARM DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1128
Mailing Address - Country:US
Mailing Address - Phone:513-942-9500
Mailing Address - Fax:513-942-9591
Practice Address - Street 1:8614 SHEPHERD FARM DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1128
Practice Address - Country:US
Practice Address - Phone:513-942-9500
Practice Address - Fax:513-942-9591
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BECKETT SPRINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350882792084P0800X
OH350811262084P0800X
OH35-0508982084P0800X
OH350508982084P0802X
OHCOA05175NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty