# BEACON SPECIALIZED LIVING OHIO INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KEYSTONE COMMUNITY RESOURCES, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1255010070
- **Legal business name:** KEYSTONE COMMUNITY RESOURCES, INC.
- **Authorized official:** JANET PELL (VP OF OPS/BIZ DEVELOPMENT)
- **Authorized official phone:** (614) 330-3073

## Contact information

- **Practice address:** 1293 REDBUD DR, FAIRBORN, OH 45324-5834
- **Practice address phone:** (937) 874-5001
- **Mailing address:** 967 WORTHINGTON WOODS LOOP RD, WORTHINGTON, OH 43085-5743
- **Mailing address phone:** (614) 330-3073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/18/2023
- **Last updated:** 07/18/2023