Provider Demographics
NPI:1164898482
Name:BEACON SENIOR SOLUTIONS, LLC
Entity Type:Organization
Organization Name:BEACON SENIOR SOLUTIONS, LLC
Other - Org Name:FIRSTLIGHT HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:MCLELLAN
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-632-0448
Mailing Address - Street 1:1400 BROWNS LN
Mailing Address - Street 2:SUITE C
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4678
Mailing Address - Country:US
Mailing Address - Phone:502-632-0448
Mailing Address - Fax:
Practice Address - Street 1:1400 BROWNS LN
Practice Address - Street 2:SUITE C
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4678
Practice Address - Country:US
Practice Address - Phone:502-632-0448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY500132251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health