Provider Demographics
NPI:1780399766
Name:BEACONARRAY GROUP
Entity type:Organization
Organization Name:BEACONARRAY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUKAYODE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINKUNLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN/ PMHNP
Authorized Official - Phone:551-795-0081
Mailing Address - Street 1:1223 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-4818
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1223 N CENTER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-4818
Practice Address - Country:US
Practice Address - Phone:551-795-0081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Multi-Specialty