Provider Demographics
NPI:1205087681
Name:MCBEAN, ERIC SCOTT
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:SCOTT
Last Name:MCBEAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2077 MILL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-2522
Mailing Address - Country:US
Mailing Address - Phone:810-820-6197
Mailing Address - Fax:
Practice Address - Street 1:2065 S. ELMS ROAD
Practice Address - Street 2:SUITE 108
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473
Practice Address - Country:US
Practice Address - Phone:810-877-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities