Beacon House

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

270001AN Issued in CA

Legal business name

BEACON HOUSE

Practice address

468 Pine Ave
Pacific Grove, CA 93950-3440

Phone

(831) 372-2334

Fax

(831) 372-2396

NPI assigned

Dec 26, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mark Willison, MFT

Title

Ceo

Phone

(831) 372-2334

Specialties & licenses 1

Addresses

Tax ID family

Beacon House2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Beacon House

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Pacific Grove, CA
  • NPI 1124675988
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Beacon House

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Pacific Grove, CA
  • NPI 1124675988
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033274485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 301",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939500301",
            "telephone_number": "831-372-2334",
            "fax_number": "831-372-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 PINE AVE",
            "city": "PACIFIC GROVE",
            "state": "CA",
            "postal_code": "939503440",
            "telephone_number": "831-372-2334",
            "fax_number": "831-372-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLISON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-372-2334",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "270001AN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Asselborn, M.D.
• Megan S Azevedo, ACSW
• Stephanie R Bacheller, LMFT
• Susan M Bajari, MA PSYCHOLOGY
• Sandy Baril, B.SC.PT
• Beacon House
• Kenneth Bear, PHARMACIST
• Marie Regine Balaba Bello, PHARMD
• Karianne Beltran, MA
• Eugene Benjamin, MD

• Substance Abuse Rehabilitation Facility in Pacific Grove, CA
• Providers in Pacific Grove, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.