# BEACON HEALTH VENTURES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Compassionate Caregivers - ELK
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477970374
- **Authorized official:** MR. GREGORY M CONRAD (PRESIDENT)
- **Authorized official phone:** (574) 647-8777

## Contact information

- **Practice address:** 3355 DOUGLAS RD, SOUTH BEND, IN 46635-1781
- **Practice address phone:** (574) 273-2273
- **Mailing address:** 5155 VERDANT ST, ELKHART, IN 46516-9315
- **Mailing address phone:** (574) 295-1111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385H00000X | Respite Care | 14-012264-1 | IN | Yes |

## Other

- **Enumeration date:** 03/28/2014
- **Last updated:** 02/27/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 100263690D | IHCP WAIVER | IN |