Provider Demographics
NPI:1568224707
Name:BEACON COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:BEACON COMMUNITY HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RESHUNDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GLOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-756-1588
Mailing Address - Street 1:8014 OVERMONT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-8261
Mailing Address - Country:US
Mailing Address - Phone:614-756-1588
Mailing Address - Fax:
Practice Address - Street 1:8014 OVERMONT RIDGE RD
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-8261
Practice Address - Country:US
Practice Address - Phone:614-756-1588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health