Beacon Specialized Living Services Inc

Organization Active NPI Family Medicine Physician · Bangor, MI

NPI 1215324876 · NPPES record last updated Jan 27, 2016

Key facts

NPI
1215324876
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BEACON SPECIALIZED LIVING SERVICES INC
Practice address
555 Railroad St
Bangor, MI 49013-1464
Phone
(269) 427-8400
NPI assigned
Apr 22, 2015
Organization subpart
Yes
Parent organization (as reported)
BEACON SPECIALIZED LIVING SERVICES INC

Authorized official

Name
Nathan Ratzlaff
Title
Owner
Phone
(269) 427-8400

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Part of
Beacon Specialized Living Services

Locations

555 Railroad St
Bangor, MI 49013
Phone (269) 427-6171

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0800X

Addresses

Primary practice location

555 Railroad St
Bangor, MI 49013-1464

Mailing address

555 Railroad St
PO Box 69
Bangor, MI 49013-1464

Other providers in Bangor, MI

All providers in Bangor, MI · Family Medicine Physician in Michigan

Sources for this page

Verify at the official NPI Registry.