BEACONWAY ISL I LLC NPI 1982872149

NPI Information

NPI: 1982872149
Provider Name: BEACONWAY ISL I, LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
2606 VILLA CT
MARSHALL, MO
ZIP 65340
Phone: (660) 229-0175
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BEACONWAY ISL I, LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Marshall, MO. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. BEACONWAY ISL I, LLC NPI is 1982872149. The provider is registered as an organization entity type.

The provider's business location address is:

2606 VILLA CT
MARSHALL, MO
ZIP 65340-711
Phone: (660) 229-0175
Fax: (660) 831-1189

The provider's authorized official is Ben Rogers .
The authorized official title is President and has the following contact phone number (660) 726-3415.

The enumeration date for this NPI number is 2/11/2008 and was last updated on 2/26/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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