Provider Demographics
NPI:1700020351
Name:BEACON POINTE, LLC
Entity Type:Organization
Organization Name:BEACON POINTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:405-848-5620
Mailing Address - Street 1:10400 VINEYARD BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-3754
Mailing Address - Country:US
Mailing Address - Phone:405-848-5620
Mailing Address - Fax:405-848-5619
Practice Address - Street 1:10400 VINEYARD BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3754
Practice Address - Country:US
Practice Address - Phone:405-848-5620
Practice Address - Fax:405-848-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health