Provider Demographics
NPI:1851688907
Name:BEACON THERAPEUTIC SCHOOLS, INC.
Entity Type:Organization
Organization Name:BEACON THERAPEUTIC SCHOOLS, INC.
Other - Org Name:BEACON THERAPEUTIC DIAGNOSTIC TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-298-1243
Mailing Address - Street 1:1912 W 103RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2625
Mailing Address - Country:US
Mailing Address - Phone:773-298-1243
Mailing Address - Fax:773-298-1078
Practice Address - Street 1:10650 S LONGWOOD DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2617
Practice Address - Country:US
Practice Address - Phone:773-881-1005
Practice Address - Fax:773-298-1078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-08
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251300000XAgenciesLocal Education Agency (LEA)
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)