Provider Demographics
NPI:1841049897
Name:BEACON BEHAVIORAL HEALTHCARE INC
Entity type:Organization
Organization Name:BEACON BEHAVIORAL HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:OLABISI
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINKUGBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-675-0253
Mailing Address - Street 1:8619 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-6711
Mailing Address - Country:US
Mailing Address - Phone:301-675-0253
Mailing Address - Fax:
Practice Address - Street 1:2323 S VOSS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3814
Practice Address - Country:US
Practice Address - Phone:301-675-0253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-14
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty