BEACON POINTE NPI 1225693534

NPI Information

NPI: 1225693534
Provider Name: BEACON POINTE
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 23D2193480

Address:
732 E CENTRE AVE
PORTAGE, MI
ZIP 49002
Phone: (269) 775-1430
Get Directions

BEACON POINTE is an assisted living facility in Portage, MI. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. BEACON POINTE NPI is 1225693534. The provider is registered as an organization entity type.

The provider's business location address is:

732 E CENTRE AVE
PORTAGE, MI
ZIP 49002-517
Phone: (269) 775-1430

The provider's authorized official is Todd Dockerty .
The authorized official title is Owner/coo and has the following contact phone number (269) 775-1430.

The CLIA number assigned to this NPI record is 23D2193480 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2019 and was last updated on 6/11/2019.

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	310400000X	Assisted Living Facility				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AL390381477	OTHER	MICHIGAN	ADULT FOSTER CARE

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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