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Beacon Specialized Living Ohio Inc

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Fairborn, OH

NPI 1255010070 · NPPES record last updated Jul 18, 2023

Key facts

NPI
1255010070
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Legal business name
BEACON SPECIALIZED LIVING OHIO INC
Practice address
1293 Redbud Dr
Fairborn, OH 45324-5834
Phone
(937) 874-5001
NPI assigned
Jul 18, 2023
Organization subpart
Yes
Parent organization (as reported)
KEYSTONE COMMUNITY RESOURCES, INC.

Authorized official

Name
Janet Pell
Title
VP of Ops/Biz Development
Phone
(614) 330-3073

Corporate family (same tax ID) 4

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

National Provider Directory

Tax ID family
Beacon Specialized Living (5 organizations share this tax ID)
Part of
Keystone Community Resources Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

1293 Redbud Dr
Fairborn, OH 45324-5834

Mailing address

967 Worthington Woods Loop Rd
Worthington, OH 43085-5743
Phone (614) 330-3073

Other providers in Fairborn, OH

All providers in Fairborn, OH · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Ohio

Sources for this page

Verify at the official NPI Registry.