Provider Demographics
NPI:1578784716
Name:BEACON STAFFING INC.
Entity Type:Organization
Organization Name:BEACON STAFFING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:UCKELE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:734-848-2400
Mailing Address - Street 1:10552 EVANS DR
Mailing Address - Street 2:UNIT 8
Mailing Address - City:LUNA PIER
Mailing Address - State:MI
Mailing Address - Zip Code:48157-9828
Mailing Address - Country:US
Mailing Address - Phone:734-848-2400
Mailing Address - Fax:734-848-2411
Practice Address - Street 1:10552 EVANS DR
Practice Address - Street 2:UNIT 8
Practice Address - City:LUNA PIER
Practice Address - State:MI
Practice Address - Zip Code:48157-9828
Practice Address - Country:US
Practice Address - Phone:734-848-2400
Practice Address - Fax:734-848-2411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704250553251J00000X
OHRN.319121251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00737ROtherSTATE INCORPORATION