Provider Demographics
NPI:1891103719
Name:BEACON HOSPICE OF NORTH DETROIT LP
Entity Type:Organization
Organization Name:BEACON HOSPICE OF NORTH DETROIT LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC ADMIN ASST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-730-2046
Mailing Address - Street 1:3406 COLLEGE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-4612
Mailing Address - Country:US
Mailing Address - Phone:409-813-2332
Mailing Address - Fax:
Practice Address - Street 1:30700 TELEGRAPH RD
Practice Address - Street 2:SUITE 3650
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4524
Practice Address - Country:US
Practice Address - Phone:313-818-3991
Practice Address - Fax:313-818-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based